MEDICARE: DR. EIN YUAN ALAN 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	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	NA 31702	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	49867	OTHER	AETNA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	F02363	OTHER	HEALTHNET
4	P850745	OTHER	OXFORD

General Provider Information

NPI Number	:	1265536544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EIN YUAN ALAN SHEN MD

Provider Business Mailing Address
First Line	:	40 UNION AVE SUITE 201
Second Line	:
City	:	IRVINGTON
State	:	NJ
Zip	:	07111-3290
Country	:	US
Telephone Number	:	973-372-6663
Fax Number	:	973-372-0322

Provider Business Practice Location Address
First Line	:	40 UNION AVE SUITE 201
Second Line	:
City	:	IRVINGTON
State	:	NJ
Zip	:	07111-3290
Country	:	US
Telephone Number	:	973-372-6663
Fax Number	:	973-372-0322

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

Provider Enumeration Date	:	09/08/2006
Last Update Date	:	07/08/2007

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