Provider Demographics
NPI:1649957903
Name:SHUKLA-ACCARDI, ANITA V
Entity type:Individual
Prefix:MRS
First Name:ANITA
Middle Name:V
Last Name:SHUKLA-ACCARDI
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ANITA
Other - Middle Name:V
Other - Last Name:SHUKLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:58 ROOSEVELT BLVD
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837-2610
Mailing Address - Country:US
Mailing Address - Phone:732-491-1290
Mailing Address - Fax:
Practice Address - Street 1:283 MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-2428
Practice Address - Country:US
Practice Address - Phone:609-744-6733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL061537001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical