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General NPI Number Information
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NPI Number | 1346784253
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Entity Type | Individual
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Provider Name | SHUANGSHUANG SHI AUD
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Gender | Female
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Dates
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Enumeration Date | 12/12/2016
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Last Update Date | 12/20/2018
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Provider Practice Location Address
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Address Line | 1589 JASON DR
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City | CINNAMINSON
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State | NJ
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Zip | 08077-1557
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Country | US
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Telephone | 615-345-5400
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Fax |
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Provider Business Mailing Address
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Address Line | 3 MARYLAND FARMS STE 200
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City | BRENTWOOD
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State | TN
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Zip | 37027-5780
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Country | US
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Telephone | 615-345-5400
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | AT006454
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 41YA00099200
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License Number State | NJ
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