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General NPI Number Information
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NPI Number | 1710628979
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Entity Type | Individual
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Provider Name | SHREYAL SHUKLA OD
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Gender | Female
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Dates
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Enumeration Date | 04/04/2022
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Last Update Date | 04/07/2022
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Provider Practice Location Address
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Address Line | 2200 ROUTE 66 STE 5
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City | NEPTUNE
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State | NJ
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Zip | 07753-4063
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Country | US
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Telephone | 732-775-0013
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Fax |
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Provider Business Mailing Address
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Address Line | 2305 TIMBER RIDGE CT
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City | PARLIN
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State | NJ
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Zip | 08859-3134
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Country | US
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Telephone | 848-260-9013
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 27OA00710100
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License Number State | NJ
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