Individual
ANNA SHOSHILOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
420 GRAND AVE, SUITE: 202, ENGLEWOOD, NJ 07631-4152
(201) 871-4040
(201) 871-7326
Mailing address
420 GRAND AVE, SUITE: 202, ENGLEWOOD, NJ 07631-4152
(201) 871-4040
(201) 871-7326
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MB69060
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
223450311
TAX ID/FHC/166 LYONS AVE
NJ
01
—
223680351
TAX ID/201LYONS AVENUE
NJ
05
—
8184801
—
NJ
Enumeration date
03/03/2006
Last updated
01/24/2017
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