Provider Demographics
NPI:1548531726
Name:SHELFORD, JASMAINE N (DPM)
Entity type:Individual
Prefix:DR
First Name:JASMAINE
Middle Name:N
Last Name:SHELFORD
Suffix:
Gender:F
Credentials:DPM
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:310 CENTRAL AVE STE 303
Mailing Address - Street 2:
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07018-2838
Mailing Address - Country:US
Mailing Address - Phone:973-337-2893
Mailing Address - Fax:201-228-1689
Practice Address - Street 1:310 CENTRAL AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018-2835
Practice Address - Country:US
Practice Address - Phone:973-337-2893
Practice Address - Fax:201-228-1689
Is Sole Proprietor?:No
Enumeration Date:2012-01-20
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MD00321800213E00000X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist