Organization
REVIVE RHEUMATOLOGY OF NORTH JERSEY, LLC
Active
Organization
REVIVE RHEUMATOLOGY OF NORTH JERSEY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAZIA SHADANI DO (PHYSICIAN)
(772) 971-5848
Entity
Organization
Contact information
Practice address
784 FRANKLIN AVE STE 250, FRANKLIN LAKES, NJ 07417-1306
(772) 971-5848
Mailing address
100 WILLOWBROOK CT, PARAMUS, NJ 07652-1833
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
—
—
Other
Enumeration date
04/29/2019
Last updated
05/26/2026
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