Provider Demographics
NPI:1023291333
Name:SAXENA, SHILPA (MD)
Entity type:Individual
Prefix:
First Name:SHILPA
Middle Name:
Last Name:SAXENA
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 1:574 SUMMIT AVE
Mailing Address - Street 2:4TH FLOOR , CONCENTRA
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-2708
Mailing Address - Country:US
Mailing Address - Phone:201-656-7678
Mailing Address - Fax:201-656-0664
Practice Address - Street 1:574 SUMMIT AVE
Practice Address - Street 2:4TH FLOOR , CONCENTRA
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-2708
Practice Address - Country:US
Practice Address - Phone:201-656-7678
Practice Address - Fax:201-656-0664
Is Sole Proprietor?:No
Enumeration Date:2007-12-10
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10027689207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine