Provider Demographics
NPI:1861225476
Name:JEFFREY A SHENFELD MD PC
Entity type:Organization
Organization Name:JEFFREY A SHENFELD MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:MISEON
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-541-1070
Mailing Address - Street 1:401 S VAN BRUNT ST STE 302
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-4604
Mailing Address - Country:US
Mailing Address - Phone:201-947-4777
Mailing Address - Fax:201-461-6160
Practice Address - Street 1:401 S VAN BRUNT ST STE 302
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-4604
Practice Address - Country:US
Practice Address - Phone:201-947-4777
Practice Address - Fax:201-461-6160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-21
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty