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Individual

DR. JONATHAN B SHAMMASH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
385 PROSPECT AVE STE 204, HACKENSACK, NJ 07601-2570
(551) 996-9150
(551) 996-9144
Mailing address
385 PROSPECT AVE STE 204, HACKENSACK, NJ 07601-2570
(551) 996-9150
(551) 996-9144

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
206910
NY
207R00000X
Internal Medicine Physician
Primary
25MA08593400
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01771219
NY
Enumeration date
10/11/2006
Last updated
04/14/2020
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