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General NPI Number Information
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NPI Number | 1316102361
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Entity Type | Organization
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Legal Business Name | RICHARD H MCSHANE
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Dates
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Enumeration Date | 07/18/2008
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Last Update Date | 07/18/2008
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Provider Practice Location Address
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Address Line | 77 N PASSAIC AVE
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City | CHATHAM
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State | NJ
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Zip | 07928-2526
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Country | US
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Telephone | 973-303-9124
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Fax | 973-635-9444
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Provider Business Mailing Address
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Address Line | PO BOX 321
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City | CEDAR GROVE
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State | NJ
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Zip | 07009-0321
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Country | US
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Telephone | 973-303-9124
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Fax | 973-635-9444
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. RICHARD H MCSHANE
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Credential | M.D
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Telephone | 973-303-9124
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2082S0105X
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Taxonomy Name | Surgery of the Hand (Plastic Surgery) Physician
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License Number | 25MA03224400
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License Number State | NJ
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