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General NPI Number Information
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NPI Number | 1184783490
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Entity Type | Individual
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Provider Name | VASUDHA CHUNDRU
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Gender | Male
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 07/12/2019
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Provider Practice Location Address
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Address Line | 574 SPRINGFIELD AVE
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City | WESTFIELD
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State | NJ
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Zip | 07090-1001
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Country | US
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Telephone | 908-518-3743
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Fax | 908-228-3621
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Provider Business Mailing Address
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Address Line | 66 W GILBERT ST 2ND FLOOR
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City | TINTON FALLS
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State | NJ
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Zip | 07701-4947
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Country | US
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Telephone | 732-212-0051
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Fax | 732-212-0713
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 25MA06628300
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License Number State | NJ
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