Individual
BENJAMIN SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A
Contact information
Practice address
141 MAIN ST, SOUTH BOUND BROOK, NJ 08880-1480
(732) 560-1234
Mailing address
141 MAIN ST, SOUTH BOUND BROOK, NJ 08880-1480
(732) 560-1234
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
25MP00306300
NJ
Other
Enumeration date
08/12/2013
Last updated
08/12/2013
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