MEDICARE: KYLE SHAW

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	213E00000X	Podiatrist	25MD00355700	NJ
2	213E00000X	Podiatrist	SC007080	PA

General Provider Information

NPI Number	:	1710410899
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYLE SHAW

Provider Business Mailing Address
First Line	:	134 BRIDGETON PIKE STE C
Second Line	:
City	:	MULLICA HILL
State	:	NJ
Zip	:	08062-2616
Country	:	US
Telephone Number	:	856-507-2783
Fax Number	:	856-221-4138

Provider Business Practice Location Address
First Line	:	364 BERLIN CROSS KEYS RD
Second Line	:
City	:	WILLIAMSTOWN
State	:	NJ
Zip	:	08094-3473
Country	:	US
Telephone Number	:	856-994-0004
Fax Number	:	856-497-5133

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

Provider Enumeration Date	:	04/06/2017
Last Update Date	:	04/03/2026

Similar Medicare Providers

1508836339 — DR. BRYAN R FERRONI DO
Practice Location Address:

364 BERLIN CROSS KEYS RD
WILLIAMSTOWN, NJ
08094-3473

Practice Phone: 856-885-2560
Practice Fax: 856-497-5302

1710258918 — MRS. ROSEMARY BRENNAN MCGONIGLE APN
Practice Location Address:

364 BERLIN CROSS KEYS RD
WILLIAMSTOWN, NJ
08094-3473

Practice Phone: 856-885-2790
Practice Fax: 856-221-4108

1336017078 — DAYMARK HEALTH NJ, PC
Practice Location Address:

316 BERRHILL DR
WILLIAMSTOWN, NJ
08094-3669

Practice Phone: 508-523-8515
Practice Fax:

1437098357 — EMPOWERED CARE SERVICES
Practice Location Address:

625 STOCKTON DR
WILLIAMSTOWN, NJ
08094-1988

Practice Phone: 856-534-1667
Practice Fax:

1962150920 — SIMONE SMITH LPC
Practice Location Address:

406 BRANDYWINE DR
WILLIAMSTOWN, NJ
08094-1690

Practice Phone: 609-271-2552
Practice Fax:

1811179377 — MS. DOROTHY M CAJUSTE APN
Practice Location Address:

1705 BIDEN LN
WILLIAMSTOWN, NJ
08094-8759

Practice Phone: 973-518-2714
Practice Fax:

Directions to “ KYLE SHAW ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.