Organization
NEW JERSEY PHYSICAL MEDICINE & REHABILITATION INSTITUTE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIRA SHIN M.D. (CEO)
(201) 261-1000
Entity
Organization
Contact information
Practice address
2050 CENTER AVE, STE 425, FORT LEE, NJ 07024-4911
(201) 261-1000
(201) 261-1188
Mailing address
2050 CENTER AVE, STE 425, FORT LEE, NJ 07024-4911
(201) 261-1000
(201) 261-1188
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
25MA07929700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1659334498
NPI FOR MIRA SHIN, M.D.
NJ
Enumeration date
05/03/2007
Last updated
02/05/2016
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