Individual
GUNJAN J SHUKLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
20 PROSPECT AVE, SUITE 701, HACKENSACK, NJ 07601-1997
(201) 996-2997
(201) 996-2571
Mailing address
82 LYONS PL, WESTWOOD, NJ 07675-1828
(201) 996-2997
(201) 996-2571
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
212477
MA
207RC0001X
Clinical Cardiac Electrophysiology Physician
241443
NY
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
25MA08120200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0130745
—
NJ
01
—
0155478
GHI PPO
NJ
05
—
2030390
—
MA
Enumeration date
09/20/2005
Last updated
07/02/2008
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