Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

David Shin

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1366112526

David Shin is a Physician Assistant in Fort Lee, New Jersey. Qualified in 2021, 5 years ago. Practices with Metro Dermatology of Nj, PA, a 5-clinician group, works from 2 locations and accepts Medicare assignment.

Years since qualifying
5
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

2175 Lemoine Ave Fl 6
Fort Lee, NJ 07024-6008
Phone: (866) 722-3338
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 14472 Northern Blvd Ste 203, Flushing, NY 11354-4231 — (718) 886-9000

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1366112526
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 17, 2021
Last updated in NPPESJanuary 26, 2022
Certification dateJanuary 26, 2022
Mailing address2175 Lemoine Ave Fl 6, Fort Lee, NJ 07024-6008

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Metro Dermatology Of Nj,Pa — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Fort Lee