Individual
SHANDEL DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
887 KINDERKAMACK RD, RIVER EDGE, NJ 07661-2307
(201) 464-0860
Mailing address
887 KINDERKAMACK RD, RIVER EDGE, NJ 07661-2307
(201) 464-0860
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
26NJ00747600
NJ
363LP2300X
Primary Care Nurse Practitioner
26NJ00747600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0587613
—
NJ
Enumeration date
08/31/2017
Last updated
12/31/2025
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