| Doctor Name: | DR. MATTHEW WARREN SHEPROW |
| NPI Number: | 1104041664 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | 3874 |
| Business Practice Address: | 3350 State Route 138 Bldg 1, Suite 117 Wall Township, NJ - 077199693 |
| Business Phone Number: | 7326812345 |
| Business Fax Number: | |
| Mailing Address: | 2158 Terrace Pl, SEA GIRT |
| State: | NJ |
| Postal Code: | 087501813 |
| Phone Number: | 7326812345 |
| Fax Number: | |
| NPI Enumeration Date: | 04/17/2007 |
| NPI Last Update Date: | 10/13/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC2200X |
| License Number: | 3874 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NJ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical Child & Adolescent |
| Taxonomy Definition: | |