Healthcare Provider Details

I. General information

NPI: 1083498778
Provider Name (Legal Business Name): SHAMS ELBEDEIWY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2023
Last Update Date: 11/28/2025
Certification Date: 11/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1387 CHEWS LANDING RD
LAUREL SPRINGS NJ
08021-2760
US

IV. Provider business mailing address

434 TERHUNE AVE
PARAMUS NJ
07652-5746
US

V. Phone/Fax

Practice location:
  • Phone: 856-454-3104
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06589100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: