Provider Demographics
NPI:1972667426
Name:KULKARNI, SHYAMKANT SAKHARAM (MD)
Entity Type:Individual
Prefix:
First Name:SHYAMKANT
Middle Name:SAKHARAM
Last Name:KULKARNI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 STUART CT
Mailing Address - Street 2:
Mailing Address - City:THOROFARE
Mailing Address - State:NJ
Mailing Address - Zip Code:08086-3810
Mailing Address - Country:US
Mailing Address - Phone:856-812-0414
Mailing Address - Fax:
Practice Address - Street 1:406 STUART CT
Practice Address - Street 2:
Practice Address - City:THOROFARE
Practice Address - State:NJ
Practice Address - Zip Code:08086-3810
Practice Address - Country:US
Practice Address - Phone:856-812-0414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08061000207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine