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General NPI Number Information
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NPI Number | 1922322197
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Entity Type | Individual
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Provider Name | BINU S SHAJIMON CRNP
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Gender | Female
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Dates
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Enumeration Date | 03/17/2010
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Last Update Date | 05/14/2019
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Provider Practice Location Address
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Address Line | 9500 NORTHEAST AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19115-3005
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Country | US
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Telephone | 215-677-4444
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Fax |
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Provider Business Mailing Address
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Address Line | 2725 SUNFLOWER WAY
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City | HUNTINGDON VALLEY
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State | PA
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Zip | 19006-5443
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Country | US
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Telephone | 267-253-0136
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP020287
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | SP014914
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | SP007508
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License Number State | PA
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