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General NPI Number Information
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NPI Number | 1336729722
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Entity Type | Individual
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Provider Name | DR. SHAWNDA MCEWEN
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Gender | Female
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Dates
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Enumeration Date | 04/10/2021
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Last Update Date | 04/10/2021
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Provider Practice Location Address
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Address Line | 21 MEADOW LN
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City | NANUET
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State | NY
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Zip | 10954-5119
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Country | US
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Telephone | 646-701-3432
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Fax |
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Provider Business Mailing Address
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Address Line | 229 MAIN ST UNIT 241
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City | FORT LEE
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State | NJ
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Zip | 07024-8810
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Country | US
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Telephone | 973-910-0773
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 44SL06018200
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License Number State | NJ
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