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NPI Code Detail

MEDICARE: DR. WILLIAM L SHINEFIELD PSY.D.

MEDICARE: DR. WILLIAM L SHINEFIELD PSY.D.
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
1103TC0700XClinical Psychologist35SI00299400NJ

General Provider Information

NPI Number : 1912925066
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM L SHINEFIELD PSY.D.
Provider Business Mailing Address
First Line : PO BOX 547
Second Line :
City : MOUNT LAUREL
State : NJ
Zip : 08054-0547
Country : US
Telephone Number : 609-744-3393
Fax Number :
Provider Business Practice Location Address
First Line : 3804 CHURCH RD
Second Line :
City : MOUNT LAUREL
State : NJ
Zip : 08054-1106
Country : US
Telephone Number : 609-744-3393
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2006
Last Update Date : 05/23/2008

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