Healthcare Provider Details

I. General information

NPI: 1538553870
Provider Name (Legal Business Name): PAUL SEBASTIAN CHIRICHELLA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2015
Last Update Date: 01/03/2025
Certification Date: 01/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 FROM RD STE 220
PARAMUS NJ
07652-3551
US

IV. Provider business mailing address

650 FROM RD STE 220
PARAMUS NJ
07652-3551
US

V. Phone/Fax

Practice location:
  • Phone: 201-342-2550
  • Fax: 201-342-7171
Mailing address:
  • Phone: 201-342-2550
  • Fax: 201-342-7171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number25MA10319700
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: