Organization
ELITE SPORTS MEDICINE AND WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAI SHOSHANI MD (OWNER/PHYSICIAN)
(201) 431-5115
Entity
Organization
Contact information
Practice address
46 UNION AVE, CRESSKILL, NJ 07626-2125
(201) 431-5115
(201) 399-7697
Mailing address
46 UNION AVE, CRESSKILL, NJ 07626-2125
(201) 431-5115
(201) 399-7697
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
25MA09267900
NJ
Other
Enumeration date
11/20/2017
Last updated
11/20/2017
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