Provider Demographics
NPI:1164117701
Name:NAIK, SHAILI SANDIP
Entity Type:Individual
Prefix:
First Name:SHAILI
Middle Name:SANDIP
Last Name:NAIK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68, MAHERNAGAR SOCIETY, BESIDE NEW INCOME TAX OFFICE
Mailing Address - Street 2:ADAJAN CHAR RASTA, ADAJAN ROAD, SURAT.
Mailing Address - City:SURAT
Mailing Address - State:GUJARAT
Mailing Address - Zip Code:395009
Mailing Address - Country:IN
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2101 N WATERMAN AVE
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92404-4836
Practice Address - Country:US
Practice Address - Phone:909-883-8711
Practice Address - Fax:909-475-5059
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program