Mira Shin is a Sports Medicine in Fort Lee, New Jersey. Mira Shin practices all healthcare services and medical treatments related to Sports Medicine. The NPI Number for Mira Shin is 1659334498. The last update date is 2016-02-05.
Mira Shin's current location address is 2050 Center Ave, Fort Lee, New Jersey. You can contact this provider via phone number 2012611000 and fax number 2012611188. The mailing address for Mira Shin is 2050 Center Ave, Fort Lee, New Jersey. To know further, please read the information below!
Provider Profile Detail
Provider Name | Mira Shin |
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Address | 2050 Center Ave, Fort Lee, New Jersey |
Phone Number | 2012611000 |
Fax Number | 2012611188 |
Sole Proprietor | Y |
Credentials | M.D. |
NPI Number Detail
NPI Number | 1659334498 |
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Provider Enumeration Date | 2006-04-11 |
Last Updated Date | 2016-02-05 |
Provider Mailing Address Detail
Address | 2050 Center Ave |
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City | Fort Lee |
State | New Jersey (NJ) |
Post Code | 70244911 |
Phone Number | 2012611000 |
Fax Number | 2012611188 |
Provider's Primary Taxonomy Detail
Speciality | Sports Medicine |
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Taxonomy | 2083S0010X |
Licence No | 25MA07929700 |
Definition: A preventive medicine physician who specializes in the diagnosis and treatment of sports related conditions and injuries. |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
---|---|---|---|
9404330 | NJ | PHCS (PRIVATE HEALTHCARE SYSTE | |
20-8831104 | NJ | TAX ID # | |
20-8831104 | NJ | MULTIPLAN | |
7687754 | NJ | AETNA PPO # | |
P3635893 | NJ | OXFORD # | |
20-8831104 | NJ | FAMILY CHOICE HEALTH | |
3K6327 | NJ | HEALTHNET (PHS) | |
161568 | NJ | GHI | |
20-8831104 | NJ | CONSUMER HEALTH NETWORK(CHN) | |
3696X1 | NY | EMPIRE BLUECROSSBLUESHIELD NY |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Mira Shin by the Centers for Medicare & Medicaid Services?
The Mira Shin has been assigned the NPI (National Provider Identifier) 1659334498 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you provide the complete physical address where Mira Shin is located?
The Mira Shin is situated at the following address: 2050 Center Ave, Fort Lee, NJ, 70244911.
What is Mira Shin's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Mira Shin is Sports Medicine, and the corresponding taxonomy classification code for this specialized field is 2083S0010X.
On what date did the Centers for Medicare & Medicaid Services issue the 1659334498 to Mira Shin?
The Mira Shin received its 1659334498 assignment from the Centers for Medicare & Medicaid Services on 2006-04-11.
As of what date were the Mira Shin's details last updated?
The information pertaining to the Mira Shin, including its address, specialty, and other details, was most recently updated on 2016-02-05.