Individual
PANKAJ R SHIROLAWALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
609 AMBOY AVE STE 101, PERTH AMBOY, NJ 08861-2577
(732) 442-2211
(732) 326-0517
Mailing address
61 ARIZONA AVE, OLD BRIDGE, NJ 08857-4317
(732) 326-0837
(732) 326-0517
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA07849500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0096920
—
NJ
05
—
02689307
—
NY
01
—
0645U1
BCBS
NY
01
—
20-4436194
QUALCARE
NJ
01
—
2623898
UNITED HEALTHCARE
NJ
01
—
2728989000
AMERIHEALTH HMO
NJ
01
—
300899
AMERIGROUP OF NJ
NJ
01
—
3K3412
HEALTHNET
NJ
01
—
5337019
CIGNA
NJ
01
—
7995802
AETNA
NJ
01
—
91002229500
AMERICHOICE
NJ
01
—
9425393
PHCS
NJ
01
—
P3719178
OXFORD
NJ
Enumeration date
02/24/2006
Last updated
12/27/2022
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