Provider Demographics
NPI:1780841270
Name:KAUL, SHAILJA (MD)
Entity Type:Individual
Prefix:
First Name:SHAILJA
Middle Name:
Last Name:KAUL
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 1:174 MIDDLETOWN BLVD STE 304
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-3201
Mailing Address - Country:US
Mailing Address - Phone:215-757-2359
Mailing Address - Fax:215-478-8026
Practice Address - Street 1:174 MIDDLETOWN BLVD STE 304
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047
Practice Address - Country:US
Practice Address - Phone:215-757-2359
Practice Address - Fax:215-478-8026
Is Sole Proprietor?:No
Enumeration Date:2008-05-21
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08824900207RE0101X
PAMT183122207RE0101X
PA430791207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0244643Medicaid