Provider Demographics
NPI:1831279504
Name:SHUKLA, NEELA JAYESH (MD)
Entity type:Individual
Prefix:DR
First Name:NEELA
Middle Name:JAYESH
Last Name:SHUKLA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:31 CYCAS
Mailing Address - Street 2:
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065-6188
Mailing Address - Country:US
Mailing Address - Phone:504-469-4867
Mailing Address - Fax:504-469-4867
Practice Address - Street 1:3 STORE HOUSE LN
Practice Address - Street 2:SUITE B
Practice Address - City:DESTREHAN
Practice Address - State:LA
Practice Address - Zip Code:70047
Practice Address - Country:US
Practice Address - Phone:985-764-6556
Practice Address - Fax:985-764-6526
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2011-06-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LA05778R173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1328511Medicaid