Provider Demographics
NPI:1700349545
Name:KANSAL, SHVETA (MD)
Entity Type:Individual
Prefix:
First Name:SHVETA
Middle Name:
Last Name:KANSAL
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 1:1610 ROUTE 88 FL 3
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-3018
Mailing Address - Country:US
Mailing Address - Phone:732-295-6571
Mailing Address - Fax:732-295-6204
Practice Address - Street 1:1610 ROUTE 88 FL 3
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-3018
Practice Address - Country:US
Practice Address - Phone:732-295-6571
Practice Address - Fax:732-295-6204
Is Sole Proprietor?:No
Enumeration Date:2019-04-09
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program