MEDICARE: EDWARD SHEN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207LP2900X	Pain Medicine (Anesthesiology) Physician	25MA09306300	NJ

General Provider Information

NPI Number	:	1093973174
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDWARD SHEN MD

Provider Business Mailing Address
First Line	:	219 S BROAD ST
Second Line	:
City	:	ELIZABETH
State	:	NJ
Zip	:	07202-3453
Country	:	US
Telephone Number	:	908-818-1600
Fax Number	:	908-818-1601

Provider Business Practice Location Address
First Line	:	219 S BROAD ST
Second Line	:	SUITE 2
City	:	ELIZABETH
State	:	NJ
Zip	:	07202-3453
Country	:	US
Telephone Number	:	201-877-0518
Fax Number	:	908-352-6181

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2008
Last Update Date	:	02/12/2026

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Directions to “ EDWARD SHEN MD” Practice Location

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