Provider Demographics
NPI:1427113620
Name:SHUKLA, MOHINI A (NP)
Entity type:Individual
Prefix:MRS
First Name:MOHINI
Middle Name:A
Last Name:SHUKLA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MOHINI
Other - Middle Name:
Other - Last Name:RAVAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 BAYER BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:WHIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07981
Mailing Address - Country:US
Mailing Address - Phone:201-599-9012
Mailing Address - Fax:
Practice Address - Street 1:100 BAYER BLVD
Practice Address - Street 2:
Practice Address - City:WHIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07981-1544
Practice Address - Country:US
Practice Address - Phone:646-962-4040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2017-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY523961-1163W00000X
NJ26NO12216200163W00000X
NY304191363LA2200X
NJ26NJ00159200363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health