Provider Demographics
NPI:1063395994
Name:SHUKLA, YASHASVI (MD)
Entity type:Individual
Prefix:DR
First Name:YASHASVI
Middle Name:
Last Name:SHUKLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2613 SOCIETY DR
Mailing Address - Street 2:
Mailing Address - City:CLAYMONT
Mailing Address - State:DE
Mailing Address - Zip Code:19703-1709
Mailing Address - Country:US
Mailing Address - Phone:610-800-5748
Mailing Address - Fax:
Practice Address - Street 1:NEMOURS CHILDREN'S HEALTH
Practice Address - Street 2:1600 ROCKLAND DRIVE
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803
Practice Address - Country:US
Practice Address - Phone:610-800-5748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL414172085P0229X
DEC7-00186792085P0229X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric Radiology