Provider Demographics
NPI:1093869075
Name:JOSYULA, SHYAMALA (MD)
Entity Type:Individual
Prefix:
First Name:SHYAMALA
Middle Name:
Last Name:JOSYULA
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 1:7 CAMBRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-5323
Mailing Address - Country:US
Mailing Address - Phone:732-238-6966
Mailing Address - Fax:
Practice Address - Street 1:203 US HIGHWAY 9
Practice Address - Street 2:
Practice Address - City:ENGLISHTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07726-8270
Practice Address - Country:US
Practice Address - Phone:732-617-8800
Practice Address - Fax:732-617-8808
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08064800207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine