Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD457622 | PA |
Y | 2080P0205X | Pediatric Endocrinologist | 25MA10684900 | NJ |
N | 2080P0205X | Pediatric Endocrinologist | MD457622 | PA |
NPI | 1265775332 |
---|---|
Provider Name | Kanika Shanker |
First Address | Boston, MA 02241-6457 |
Second Address | Morristown, NJ 07960-7337 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2013 |
Last Update Date | 17/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
103115201 | (05) | PA |