Healthcare Provider Details

I. General information

NPI: 1316412083
Provider Name (Legal Business Name): FATIMA SHELL-SANCHEZ MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2018
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 HACKENSACK AVE STE 200
HACKENSACK NJ
07601-6451
US

IV. Provider business mailing address

411 HACKENSACK AVE
HACKENSACK NJ
07601-6328
US

V. Phone/Fax

Practice location:
  • Phone: 201-960-4782
  • Fax: 732-560-8080
Mailing address:
  • Phone: 201-960-4782
  • Fax: 734-256-0808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number0450403356
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number533441-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: