Healthcare Provider Details

I. General information

NPI: 1588191100
Provider Name (Legal Business Name): NINA SHINWAY PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2017
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 WASHINGTON ST STE 304
HOBOKEN NJ
07030-5162
US

IV. Provider business mailing address

306 WASHINGTON ST STE 304
HOBOKEN NJ
07030-5162
US

V. Phone/Fax

Practice location:
  • Phone: 201-572-6191
  • Fax:
Mailing address:
  • Phone: 201-572-6191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number5779
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number022109
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number9824
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number9824
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: