Individual
MISS SUZETT SIMONE SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
2 UNIVERSITY PLZ STE 204, HACKENSACK, NJ 07601-6211
(551) 295-8223
Mailing address
2 UNIVERSITY PLZ STE 204, HACKENSACK, NJ 07601-6211
(551) 295-8223
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
26NJ00645900
NJ
363LP2300X
Primary Care Nurse Practitioner
Primary
26NJ00645900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0760081
—
NJ
Enumeration date
09/01/2016
Last updated
09/14/2025
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