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Contact Information

SHAZAM BACCHUS, APN
459 N 7TH ST FL 1
NEWARK, NJ07107-3743
 Phone: 973-388-9560
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Primary Care

363LP2300X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for SHAZAM BACCHUS · (Male)

NPI Number 1972133254
Status Active
Credentials APN
Entity Individual
Enumeration date 01/24/2020
Last updated 01/24/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • NJ License # 26NJ01004000
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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