Provider Demographics
NPI:1821447145
Name:SHAREDALAL, PARIJA
Entity Type:Individual
Prefix:DR
First Name:PARIJA
Middle Name:
Last Name:SHAREDALAL
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:NORTHSHORE UNIVERSITY HOSPITAL
Mailing Address - Street 2:300 COMMUNITY DR
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030
Mailing Address - Country:US
Mailing Address - Phone:516-562-0100
Mailing Address - Fax:
Practice Address - Street 1:245 N 15TH ST FL 6
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-1101
Practice Address - Country:US
Practice Address - Phone:215-762-7000
Practice Address - Fax:215-762-7765
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-07
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT211845207R00000X
NY306404207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine