Active NPI
Shirley Sostre-Oquendo, MD
- Child & Adolescent Psychiatry Physician
- Hackensack, NJ
National Provider Identifier
1710121991
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- 25MA0940340
- Practice address
- 450 Summit Ave
Hackensack, NJ 07601-1503 - Phone
- (201) 294-1245
- NPI assigned
- May 1, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Child & Adolescent Psychiatry Physician | 2084P0804X | 25MA0940340 | NJ | Primary |
Addresses
Primary practice location
450 Summit Ave
Hackensack, NJ 07601-1503
Mailing address
450 Summit Ave
Hackensack, NJ 07601-1503
Phone (201) 294-1245
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA0940340 | NJ | MD | Child & Adolescent Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1241136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598572800000",
"number": "1710121991",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "450 SUMMIT AVE",
"city": "HACKENSACK",
"state": "NJ",
"postal_code": "076011503",
"telephone_number": "201-294-1245"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 SUMMIT AVE",
"city": "HACKENSACK",
"state": "NJ",
"postal_code": "076011503",
"telephone_number": "201-294-1245"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOSTRE-OQUENDO",
"first_name": "SHIRLEY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-05-01",
"last_updated": "2020-08-28",
"certification_date": "2020-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "NJ",
"license": "25MA0940340",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hackensack, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.