Healthcare Provider Details

I. General information

NPI: 1174706618
Provider Name (Legal Business Name): VIVIAN SHNAIDMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: VIVIAN CHERN M.D.

II. Dates (important events)

Enumeration Date: 12/06/2007
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

475 WALL ST
PRINCETON NJ
08540-1509
US

IV. Provider business mailing address

475 WALL ST
PRINCETON NJ
08540-1509
US

V. Phone/Fax

Practice location:
  • Phone: 609-910-1715
  • Fax: 609-964-1700
Mailing address:
  • Phone: 609-910-1715
  • Fax: 609-964-1700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number250MA6310500
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License Number000025MA63105
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number250MA6310500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: