MEDICARE: DR. SHEENA JOSEPH JOHN D.O.

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	207P00000X	Emergency Medicine Physician	25MB08392400	NJ

General Provider Information

NPI Number	:	1275794794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHEENA JOSEPH JOHN D.O.

Provider Business Mailing Address
First Line	:	201 LYONS AVE
Second Line	:	SUITE D11
City	:	NEWARK
State	:	NJ
Zip	:	07112-2027
Country	:	US
Telephone Number	:	973-926-7000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2317 CENTER ISLAND ROUTE 22
Second Line	:
City	:	UNION
State	:	NJ
Zip	:	07083
Country	:	US
Telephone Number	:	201-354-1951
Fax Number	:

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

Provider Enumeration Date	:	06/18/2008
Last Update Date	:	02/10/2022

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