Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | MA046972 | NJ |
NPI | 1033284096 |
---|---|
Provider Name | Naresh Chanderi |
First Address | Hackensack, NJ 07601-2602 |
Second Address | Hackensack, NJ 07601-2602 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0981109 | (05) | NJ |
C08179 | (02) |