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NPI 1336140029

NPI 1336140029 : SHONDA M. CORBETT MD : TEANECK, NJ

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General NPI Number Information
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    NPI Number           |    1336140029
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    Entity Type          |    Individual 
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    Provider Name        |    SHONDA M. CORBETT MD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/03/2005
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    Last Update Date     |    03/06/2023
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Provider Practice Location Address
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    Address Line         |    718 TEANECK RD STE 301 
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    City                 |    TEANECK
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    State                |    NJ
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    Zip                  |    07666-4245
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    Country              |    US
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    Telephone            |    551-288-1025
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3 UNIVERSITY PLZ STE 205 
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    City                 |    HACKENSACK
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    State                |    NJ
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    Zip                  |    07601-6208
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    Country              |    US
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    Telephone            |    201-833-3000
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207V00000X
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    Taxonomy Name        |    Obstetrics & Gynecology Physician
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    License Number       |    228897
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    License Number State |    NY
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Taxonomy #2
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    Taxonomy Code        |    207V00000X
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    Taxonomy Name        |    Obstetrics & Gynecology Physician
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    License Number       |    25MA09967200
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    License Number State |    NJ
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