Healthcare Provider Details

I. General information

NPI: 1295421527
Provider Name (Legal Business Name): SHANY SHAJI APN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2023
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 COLUMBIA TPKE
FLORHAM PARK NJ
07932-1299
US

IV. Provider business mailing address

222 COLUMBIA TPKE
FLORHAM PARK NJ
07932-1299
US

V. Phone/Fax

Practice location:
  • Phone: 973-267-1238
  • Fax: 973-540-8849
Mailing address:
  • Phone: 973-261-9075
  • Fax: 973-593-2063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ01467800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: