Organization
SHORE NURSE PRACTITIONER GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MUSTAK RAHMAN CPC,CPC-H (MANAGER)
(848) 466-6011
Entity
Organization
Contact information
Practice address
71 ANNAPOLIS ST, TINTON FALLS, NJ 07712-3175
(848) 466-6011
(732) 493-8475
Mailing address
71 ANNAPOLIS ST, TINTON FALLS, NJ 07712-3175
(848) 466-6011
(732) 493-8475
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
26NJ00037000
NJ
Other
Enumeration date
11/05/2009
Last updated
11/05/2009
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