Provider Demographics
NPI:1144698622
Name:SHUKLA MEDICAL SERVICES PLLC
Entity type:Organization
Organization Name:SHUKLA MEDICAL SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHANA
Authorized Official - Middle Name:RAMESH
Authorized Official - Last Name:SHUKLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-636-2611
Mailing Address - Street 1:150 LOCKWOOD AVE STE 30
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-4914
Mailing Address - Country:US
Mailing Address - Phone:914-636-2611
Mailing Address - Fax:914-636-0987
Practice Address - Street 1:150 LOCKWOOD AVE STE 30
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-4914
Practice Address - Country:US
Practice Address - Phone:914-636-2611
Practice Address - Fax:914-636-0987
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-14
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY277625207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty