Organization · NPI-2

David Shaker DO LLC

Clinic/Center · Hackensack, NJ

NPI number1548756786
StatusActive
Last updated in NPPESJul 10, 2018

Details

NPI
1548756786
Entity type
Organization (NPI-2)
Legal business name
David Shaker DO LLC
Organization subpart
No
Enumeration date
Jul 10, 2018
Last updated
Jul 10, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center25BM10243200NJYes

Practice location

38 Summit Ave
Hackensack, NJ 07601-1263

Phone 201-343-6360

Mailing address

38 Summit Ave
Hackensack, NJ 07601-1263

Phone 201-343-6360

Authorized official

David Shaker
Owner
2013436360

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Clinic/Center providers in Hackensack, NJ