Individual provider · Type 1 NPI
Shazam Bacchus, APN
Primary Care Nurse Practitioner · Newark, NJ
NPI number
1972133254
Active
Practice location
459 N 7th St Fl 1
Newark, NJ 07107-3743
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Nurse Practitioner Primary | 363LP2300X | 26NJ01004000 (NJ) |
Primary Care Nurse Practitioner: Definition to come...
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About NPI 1972133254
Shazam Bacchus, APN's National Provider Identifier is 1972133254, issued on Jan 24, 2020. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Newark, NJ. The record was last updated on Jan 24, 2020.