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General NPI Number Information
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NPI Number | 1407310329
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Entity Type | Organization
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Legal Business Name | UNIVERSITY HEALTH PROFESSIONS
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Dates
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Enumeration Date | 01/24/2019
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Last Update Date | 01/24/2019
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Provider Practice Location Address
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Address Line | 166 LYONS AVE
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City | NEWARK
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State | NJ
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Zip | 07112-2016
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Country | US
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Telephone | 973-972-5350
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Fax |
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Provider Business Mailing Address
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Address Line | 65 BERGEN ST
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City | NEWARK
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State | NJ
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Zip | 07107-3001
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | COO
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Name | KAREN SHAPIRO
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Credential |
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Telephone | 973-972-0297
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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