Search › New Jersey › 363A00000X
Shannon Radkovich, PA-C
NPI 1215292099 · on the registry since 2012
Practice
- Address
- 714 Route 10 W
Randolph, NJ 07869 - Phone
- (973) 891-1213
- Fax
- (973) 891-1216
- Clinicians at this address
- 3
Additional practice sites
- 1 Diamond Hill Rd, Berkeley Heights, NJ
Registry record
- Primary taxonomy
- 363A00000X
363A00000X
- Licence states on file
- NJ
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2023-05-10
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New Jersey