Individual
TIMOTHY MCSHANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APN
Contact information
Practice address
875 KINGS HWY STE 100, WEST DEPTFORD, NJ 08096-3165
(856) 251-0500
(856) 797-4785
Mailing address
765 ROUTE 70 E BLDG A100, MARLTON, NJ 08053-2341
(856) 983-3900
(856) 797-4785
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
26NJ01030100
NJ
Other
Enumeration date
04/22/2020
Last updated
04/22/2020
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