Individual
PHEODORA SHIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 MADISON AVE, MORRISTOWN, NJ 07960-6136
(800) 991-9133
(201) 943-8733
Mailing address
PO BOX 18086, NEWARK, NJ 07191-8086
(201) 943-5991
(201) 943-8733
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MA062874
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6710107
—
NJ
Enumeration date
11/16/2005
Last updated
07/09/2007
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