Provider Demographics
NPI:1093786212
Name:HAJELA, SHAILENDRA (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAILENDRA
Middle Name:
Last Name:HAJELA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 NEWARK AVE
Mailing Address - Street 2:JERSEY REHAB PA
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109-1123
Mailing Address - Country:US
Mailing Address - Phone:973-844-9220
Mailing Address - Fax:973-844-9221
Practice Address - Street 1:15 NEWARK AVE
Practice Address - Street 2:15 NEWARK AVE
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109-1123
Practice Address - Country:US
Practice Address - Phone:973-844-9220
Practice Address - Fax:973-844-9221
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA082079002081P2900X
NY2581652081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ136040DERMedicare PIN
I31751Medicare UPIN
NJ784955Medicare PIN
NYA400081140Medicare PIN
NYA100001253Medicare PIN