Provider Demographics
NPI:1750473286
Name:MALI, SHALINI R (MD)
Entity Type:Individual
Prefix:DR
First Name:SHALINI
Middle Name:R
Last Name:MALI
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 1:206 CLAREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-3410
Mailing Address - Country:US
Mailing Address - Phone:973-746-0009
Mailing Address - Fax:973-746-7911
Practice Address - Street 1:206 CLAREMONT AVE
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042
Practice Address - Country:US
Practice Address - Phone:973-746-0009
Practice Address - Fax:973-746-7911
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2018-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07371500207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP00181759OtherRAILROAD MEDICARE
NJ0007447Medicaid
NJP00181759OtherRAILROAD MEDICARE
NJH95803Medicare UPIN