Shukla, Pratik A

Shukla, Pratik A is an sole proprietor health care provider with primary practice located at 150 Bergen St # Streetc , Newark NJ 07103. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Shukla, Pratik A can be contacted via phone (973) 972-5188.

Contact Information

Primary practice address
150 Bergen St # Streetc Newark NJ 07103
Phone: (973) 972-5188
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MT202262 Pennsylvania
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 25MA10336900 New Jersey

Profile Details

NPI number 1457614141
LBN Legal business name Shukla, Pratik A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 19th, 2012
Last updated Mar 27th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457614141 NPPES
New Jersey MEDICAID 0640930

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