Individual
RABIE M SHANTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, MD
Contact information
Practice address
110 BERGEN ST RM B-854, NEWARK, NJ 07103-2495
(739) 972-3126
(973) 972-7322
Mailing address
110 BERGEN ST RM B-854, NEWARK, NJ 07103-2495
(739) 972-3126
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
22DI02438500
NJ
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
MD458380
PA
207Y00000X
Otolaryngology Physician
MD458380
PA
207YS0012X
Sleep Medicine (Otolaryngology) Physician
MD458380
PA
Other
Enumeration date
08/17/2010
Last updated
08/04/2022
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