Provider Demographics
NPI:1962808519
Name:SHORE SPECIALTY CONSULTANTS
Entity type:Organization
Organization Name:SHORE SPECIALTY CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ULICES
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ FELIZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-965-6200
Mailing Address - Street 1:1 EAST NEW YORK AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERS POINT
Mailing Address - State:NJ
Mailing Address - Zip Code:08244
Mailing Address - Country:US
Mailing Address - Phone:609-653-3500
Mailing Address - Fax:609-926-4311
Practice Address - Street 1:1 EAST NEW YORK AVE
Practice Address - Street 2:
Practice Address - City:SOMERS POINT
Practice Address - State:NJ
Practice Address - Zip Code:08244
Practice Address - Country:US
Practice Address - Phone:609-653-3500
Practice Address - Fax:609-926-4311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-10
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty