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General NPI Number Information
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NPI Number | 1114981735
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Entity Type | Individual
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Provider Name | SHANTHI CHEZIAN MD
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Gender | Female
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Dates
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Enumeration Date | 04/12/2006
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 47825 OASIS ST
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City | INDIO
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State | CA
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Zip | 92201-6950
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Country | US
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Telephone | 760-863-8455
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Fax |
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Provider Business Mailing Address
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Address Line | 23 CENTRAL SQUARE PARK
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City | METUCHEN
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State | NJ
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Zip | 08840-1873
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Country | US
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Telephone | 732-343-5348
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 25MA07675000
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A84488
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License Number State | CA
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