Provider Demographics
NPI:1396799433
Name:SHIN, HELEN THERESA (MD)
Entity type:Individual
Prefix:DR
First Name:HELEN
Middle Name:THERESA
Last Name:SHIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:155 POLIFLY RD STE 101
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-1749
Mailing Address - Country:US
Mailing Address - Phone:551-996-8697
Mailing Address - Fax:201-441-9963
Practice Address - Street 1:155 POLIFLY RD STE 101
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1749
Practice Address - Country:US
Practice Address - Phone:515-996-8697
Practice Address - Fax:201-441-9963
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA07758000207NP0225X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJH26945Medicare UPIN