Individual
PETER YONG SEUNG SHIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
185 S ORANGE AVE, NEWARK, NJ 07103-2757
(973) 972-4300
Mailing address
1275 15TH ST APT 18E, FORT LEE, NJ 07024-1935
(201) 978-4758
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
306709
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/15/2015
Last updated
04/07/2022
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