Individual
DR. MIRA SHIN
Active
Individual
DR. MIRA SHIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
25MA07929700
NJ
208100000X
Physical Medicine & Rehabilitation Physician
Primary
25MA07929700
NJ
2081H0002X
Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician
25MA07929700
NJ
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
25MA07929700
NJ
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
25MA07929700
NJ
2083S0010X
Sports Medicine (Preventive Medicine) Physician
25MA07929700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1151716
AETNA HMO #
NJ
01
—
161568
GHI
NJ
01
—
1749400
CIGNA
NJ
01
—
20-8831104
TAX ID #
NJ
01
—
3696X1
EMPIRE BLUECROSSBLUESHIELD NY (WELL CHOICE)
NY
01
—
3K2116
HEALTHNET #
NJ
01
—
3K6327
HEALTHNET (PHS)
NJ
01
—
7687754
AETNA PPO #
NJ
01
—
9404330
PHCS (PRIVATE HEALTHCARE SYSTEMS)
NJ
01
—
P3635893
OXFORD #
NJ
Enumeration date
04/11/2006
Last updated
02/05/2016
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up