institution
Shan Nagendra,m.d.p.c.
Specialist in Bayonne, New Jersey
NPI 1174705776

Shan Nagendra,m.d.p.c. is a Specialist based in Bayonne, NJ. Shan Nagendra,m.d.p.c. practices in Bayonne, NJ. The NPI Number for Shan Nagendra,m.d.p.c. is 1174705776 and holds a License No. MA30013 (New Jersey).

The current practice location address for Shan Nagendra,m.d.p.c. is 654 Avenue C, Bayonne, NJ and can be reached out via phone at 201-823-3390 and via fax at 201-823-4420.

Location: 654 Avenue C, Bayonne, NJ, 07002-3899
institution
Provider Profile Details
NPI Number
1174705776
Provider Name
Shan Nagendra,m.d.p.c.
Credential
Provider Entity Type
Organization
Address
654 Avenue C, Bayonne, NJ, 07002-3899
Phone Number
201-823-3390
Fax Number
201-823-4420
Provider Enumeration Date
12/05/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
3195503 05 NJ
institution
Provider Business Practice Location Address Details
Address
654 Avenue C
City
State
Zip
07002-3899
Phone Number
201-823-3390
Fax Number
201-823-4420
person
Provider Business Mailing Address Details
Address
654 Avenue C
City
State
Zip
07002-3899
Phone Number
201-823-3390
Fax Number
201-823-4420
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
License No.
MA30013 (New Jersey)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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