| David Shaker Do Llc | |
|
38 Summit Ave Hackensack NJ 07601-1263 | |
| (201) 343-6360 | |
| Not Available |
| Full Name | David Shaker Do Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 38 Summit Ave, Hackensack, New Jersey |
| Authorized Official Name and Position | David Shaker (OWNER) |
| Authorized Official Contact | 2013436360 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| David Shaker Do Llc 38 Summit Ave Hackensack NJ 07601-1263 Ph: (201) 343-6360 | David Shaker Do Llc 38 Summit Ave Hackensack NJ 07601-1263 Ph: (201) 343-6360 |
| NPI Number | 1548756786 |
|---|---|
| Provider Enumeration Date | 07/10/2018 |
| Last Update Date | 07/10/2018 |
| Medicare PECOS PAC ID | 5395092068 |
|---|---|
| Medicare Enrollment ID | O20180726001103 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548756786 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 25BM10243200 (New Jersey) | Primary |
| Provider Name | David Shaker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396130365 PECOS PAC ID: 0143585174 Enrollment ID: I20180523000133 |
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