Provider Demographics
NPI:1538123351
Name:IYENGAR, SASHIKALA (MD)
Entity type:Individual
Prefix:
First Name:SASHIKALA
Middle Name:
Last Name:IYENGAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 GLADSTONE DR
Mailing Address - Street 2:
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-3422
Mailing Address - Country:US
Mailing Address - Phone:973-335-4598
Mailing Address - Fax:
Practice Address - Street 1:127 GLADSTONE DR
Practice Address - Street 2:
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-3422
Practice Address - Country:US
Practice Address - Phone:973-335-4598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-17
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02935000208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics