Healthcare Provider Details

I. General information

NPI: 1023291333
Provider Name (Legal Business Name): SHILPA SAXENA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2007
Last Update Date: 07/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

574 SUMMIT AVE 4TH FLOOR , CONCENTRA
JERSEY CITY NJ
07306-2708
US

IV. Provider business mailing address

574 SUMMIT AVE 4TH FLOOR , CONCENTRA
JERSEY CITY NJ
07306-2708
US

V. Phone/Fax

Practice location:
  • Phone: 201-656-7678
  • Fax: 201-656-0664
Mailing address:
  • Phone: 201-656-7678
  • Fax: 201-656-0664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberBP10027689
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: