Individual
SHAUNA MACKENZIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
703 MAIN ST, PATERSON, NJ 07503-2621
(973) 754-2000
Mailing address
703 MAIN ST, PATERSON, NJ 07503-2621
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
25MA10208900
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/17/2014
Last updated
02/05/2019
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