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General NPI Number Information
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NPI Number | 1457575540
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Entity Type | Organization
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Legal Business Name | SHATKIN CARDIOLOGY, LLC
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 03/22/2016
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Provider Practice Location Address
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Address Line | 9901 SEAPOINTE BLVD
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City | WILDWOOD CREST
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State | NJ
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Zip | 08260-6203
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Country | US
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Telephone | 609-774-5372
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Fax |
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Provider Business Mailing Address
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Address Line | 6083 WILDCAT RUN
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City | WEST PALM BEACH
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State | FL
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Zip | 33412-3006
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Country | US
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Telephone | 609-774-5372
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. BENNETT SHATKIN
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Credential | MD
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Telephone | 609-774-5372
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MA52095
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License Number State | NJ
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