Individual
KISHORCHANDRA S. SHUKLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
59 KOCH AVE, MORRIS PLAINS, NJ 07950-4400
(973) 538-1800
Mailing address
59 KOCH AVE, MORRIS PLAINS, NJ 07950-4400
(973) 933-2160
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA03390600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
717748C2E
MEDICARE BILLING NO.
NJ
Enumeration date
12/06/2006
Last updated
02/25/2009
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