Individual
SCOTT SHANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
73 W END AVE, SOMERVILLE, NJ 08876-1828
(908) 256-6965
Mailing address
274 ROSEWOOD LN, PORT READING, NJ 07064-1243
(732) 925-8386
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
37AC00736500
NJ
Other
Enumeration date
08/16/2023
Last updated
08/16/2023
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