Individual
MISS SHANNON URENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
80 JAMES ST FL 2, EDISON, NJ 08820-3938
(732) 635-9300
Mailing address
331 NEWMAN SPRINGS RD STE 220, RED BANK, NJ 07701-5792
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00855300
NJ
363A00000X
Physician Assistant
50.006053RX
OH
Other
Enumeration date
08/02/2019
Last updated
11/14/2024
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