=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619531142
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHRISTINA SHEIL MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/30/2019
-----------------------------------------------------
Last Update Date | 04/30/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 101 CARNEGIE CTR STE 101
-----------------------------------------------------
City | PRINCETON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08540-6231
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-250-7356
-----------------------------------------------------
Fax | 732-305-6309
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 103 HIDDEN LAKE DR
-----------------------------------------------------
City | NORTH BRUNSWICK
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08902-1203
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-599-5941
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | MA057322
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------