Individual
SHANTELLE DAGUILH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
473 RIVER RD STE 114, EDGEWATER, NJ 07020-1145
(201) 679-0089
Mailing address
1204 85TH ST, NORTH BERGEN, NJ 07047-4328
(201) 679-0089
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
26NJ01414300
NJ
363L00000X
Nurse Practitioner
Primary
350427
NY
363L00000X
Nurse Practitioner
F350427
NY
Other
Enumeration date
01/02/2023
Last updated
02/26/2023
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