Provider Demographics
NPI:1952727323
Name:PANDYA, SHILIN R (DO)
Entity Type:Individual
Prefix:DR
First Name:SHILIN
Middle Name:R
Last Name:PANDYA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:SHILIN
Other - Middle Name:R
Other - Last Name:RASANIYA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:27 MOUNTAIN BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07059-5605
Mailing Address - Country:US
Mailing Address - Phone:732-907-7362
Mailing Address - Fax:343-503-0648
Practice Address - Street 1:27 MOUNTAIN BLVD STE 3
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-5605
Practice Address - Country:US
Practice Address - Phone:732-907-7362
Practice Address - Fax:343-503-0648
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-10
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB094793002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry