Individual
MRS. HENNA S. SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
107 MONMOUTH RD STE 102, WEST LONG BRANCH, NJ 07764-1021
(732) 641-3350
Mailing address
1 BRIDGE AVE APT 201, RED BANK, NJ 07701-1537
(248) 925-0923
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NR18059800
NJ
363LF0000X
Family Nurse Practitioner
Primary
26NJ00724700
NJ
Other
Enumeration date
02/20/2017
Last updated
01/15/2019
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