Shin, Mira

Shin, Mira is an sole proprietor health care provider with primary practice located at 2050 Center Ave Ste 425, Fort Lee NJ 07024-4911. She recently has 5 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine, Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation is her primary health care specialty. Shin, Mira can be contacted via phone (201) 261-1000.

Contact Information

Primary practice address
2050 Center Ave Ste 425 Fort Lee NJ 07024-4911
Phone: (201) 261-1000
Fax: (201) 261-1188
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 25MA07929700 New Jersey
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 25MA07929700 New Jersey
Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine 2081H0002X 25MA07929700 New Jersey
Allopathic & Osteopathic Physicians / Pain Medicine 2081P2900X 25MA07929700 New Jersey
Allopathic & Osteopathic Physicians / Sports Medicine 2081S0010X 25MA07929700 New Jersey
Allopathic & Osteopathic Physicians / Sports Medicine 2083S0010X 25MA07929700 New Jersey

Profile Details

NPI number 1659334498
LBN Legal business name Shin, Mira
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 11th, 2006
Last updated Feb 5th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659334498 NPPES
New Jersey Other 9404330 PHCS (PRIVATE HEALTHCARE SYSTEMS)
New Jersey Other 20-8831104 PHCS (PRIVATE HEALTHCARE SYSTEMS)
New Jersey Other 20-8831104 PHCS (PRIVATE HEALTHCARE SYSTEMS)
New Jersey Other 7687754 PHCS (PRIVATE HEALTHCARE SYSTEMS)
New Jersey Other P3635893 PHCS (PRIVATE HEALTHCARE SYSTEMS)
New Jersey Other 20-8831104 PHCS (PRIVATE HEALTHCARE SYSTEMS)
New Jersey Other 3K6327 PHCS (PRIVATE HEALTHCARE SYSTEMS)
New Jersey Other 161568 PHCS (PRIVATE HEALTHCARE SYSTEMS)
New Jersey Other 20-8831104 PHCS (PRIVATE HEALTHCARE SYSTEMS)
New Jersey Other 3696X1 PHCS (PRIVATE HEALTHCARE SYSTEMS)
New Jersey Other 1151716 PHCS (PRIVATE HEALTHCARE SYSTEMS)
New Jersey Other 1749400 PHCS (PRIVATE HEALTHCARE SYSTEMS)
New Jersey Other 3K2116 PHCS (PRIVATE HEALTHCARE SYSTEMS)

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