Provider Demographics
NPI:1871694570
Name:SHAMASH, FELIX SHAOUL (MD)
Entity type:Individual
Prefix:DR
First Name:FELIX
Middle Name:SHAOUL
Last Name:SHAMASH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 KRAMER CT
Mailing Address - Street 2:
Mailing Address - City:OAKHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07755-1523
Mailing Address - Country:US
Mailing Address - Phone:323-641-0107
Mailing Address - Fax:732-364-1991
Practice Address - Street 1:4618 ROUTE 9
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-3319
Practice Address - Country:US
Practice Address - Phone:732-364-1010
Practice Address - Fax:732-364-1991
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ52518208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6540902Medicaid
NJE13247Medicare UPIN
NJ197132Medicare ID - Type Unspecified