Healthcare Provider Details

I. General information

NPI: 1316987670
Provider Name (Legal Business Name): ADAM SHOMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 HUDSON ST STE 2
HOBOKEN NJ
07030-5795
US

IV. Provider business mailing address

104 HUDSON ST STE 2
HOBOKEN NJ
07030-5795
US

V. Phone/Fax

Practice location:
  • Phone: 201-342-7002
  • Fax: 201-342-7055
Mailing address:
  • Phone: 201-342-7002
  • Fax: 201-342-7055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberQ9906
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberQ9906
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number25MA07463800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: