Healthcare Provider Details

I. General information

NPI: 1811300429
Provider Name (Legal Business Name): DR. PRAPTI Y SHINGALA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2014
Last Update Date: 09/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

483 CRANBURY RD
EAST BRUNSWICK NJ
08816
US

IV. Provider business mailing address

579A CRANBURY RD
EAST BRUNSWICK NJ
08816-5426
US

V. Phone/Fax

Practice location:
  • Phone: 732-390-0040
  • Fax: 732-955-8874
Mailing address:
  • Phone: 732-390-0040
  • Fax: 732-955-8874

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number25MA10552500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: