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General NPI Number Information
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NPI Number | 1508597170
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Entity Type | Individual
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Provider Name | SHAMEL F DINGLE
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Gender | Male
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Dates
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Enumeration Date | 06/23/2022
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Last Update Date | 06/23/2022
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Provider Practice Location Address
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Address Line | 680 JOHN F. KENNEDY BOULEVARD APT.205
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City | BAYONNE
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State | NJ
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Zip | 07002-0700
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Country | US
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Telephone | 201-884-3672
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Fax |
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Provider Business Mailing Address
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Address Line | 1091-93 BROAD ST
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City | NEWARK
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State | NJ
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Zip | 07114
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Country | US
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Telephone | 862-270-6137
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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