Provider Demographics
NPI:1013597715
Name:ACHARYA, SHRIJA
Entity type:Individual
Prefix:
First Name:SHRIJA
Middle Name:
Last Name:ACHARYA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9626 VINCA CIR APT A
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28213-0012
Mailing Address - Country:US
Mailing Address - Phone:704-763-0721
Mailing Address - Fax:
Practice Address - Street 1:1004 PROCURE ST STE 100
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-2620
Practice Address - Country:US
Practice Address - Phone:919-577-0085
Practice Address - Fax:910-891-5323
Is Sole Proprietor?:No
Enumeration Date:2021-04-08
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC106S00000X
NC0010-14440363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician