Bacchus, Shazam

Bacchus, Shazam is an individual health care provider with primary practice located at 459 N 7Th St Fl 1 , Newark NJ 07107-3743. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Primary Care, which is considered as his primary health care specialty. Bacchus, Shazam can be contacted via phone (973) 388-9560.

Contact Information

Primary practice address
459 N 7Th St Fl 1 Newark NJ 07107-3743
Phone: (973) 388-9560
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X 26NJ01004000 New Jersey

Profile Details

NPI number 1972133254
LBN Legal business name Bacchus, Shazam
Credentials Advanced Practice Nurse (APN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 24th, 2020
Last updated Jan 24th, 2020 - about 6 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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