Individual
SHIVANI D THAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
963 US HIGHWAY 9, SOUTH AMBOY, NJ 08879-3302
(732) 952-3627
Mailing address
963 US HIGHWAY 9, SOUTH AMBOY, NJ 08879-3302
(732) 952-3627
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/11/2019
Last updated
10/19/2022
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