Healthcare Provider Details

I. General information

NPI: 1003110347
Provider Name (Legal Business Name): JERSEY FORENSIC CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2010
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

181 CHERRY VALLEY RD
PRINCETON NJ
08540-7911
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 TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number25MA06310500
License Number StateNJ

VIII. Authorized Official

Name: DR. VIVIAN SHNAIDMAN
Title or Position: OWNER
Credential: MD
Phone: 609-910-1715