Provider Demographics
NPI:1649438482
Name:JHA, SHALINI (MB BCH BAO)
Entity type:Individual
Prefix:
First Name:SHALINI
Middle Name:
Last Name:JHA
Suffix:
Gender:F
Credentials:MB BCH BAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 COLCHESTER AVENUE WEST PAVILION 2-272
Mailing Address - Street 2:FLETCHER ALLEN HEALTH CARE ATTN ANN MURRAY GRAD MED ED
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401
Mailing Address - Country:US
Mailing Address - Phone:802-656-2156
Mailing Address - Fax:802-656-8577
Practice Address - Street 1:111 COLCHESTER AVENUE
Practice Address - Street 2:FLETCHER ALLEN HEALTH CARE WEST PAVILION 2-272
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401
Practice Address - Country:US
Practice Address - Phone:802-656-2156
Practice Address - Fax:802-656-8577
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-29
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program