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General NPI Number Information
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NPI Number | 1275700809
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Entity Type | Organization
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Legal Business Name | KOKILA CHANDARANA, M.D; PA
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Dates
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Enumeration Date | 05/13/2008
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Last Update Date | 05/13/2008
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Provider Practice Location Address
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Address Line | 140 PARK AVE WINDSOR GARDEN CARE CENTER
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City | EAST ORANGE
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State | NJ
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Zip | 07017-5248
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Country | US
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Telephone | 973-677-1500
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Fax | 973-675-0512
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Provider Business Mailing Address
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Address Line | 24 NOTTINGHAM WAY
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City | WARREN
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State | NJ
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Zip | 07059-6753
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Country | US
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Telephone | 908-580-1025
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Fax | 908-548-0849
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KOKILA SHASHIKANT CHANDARANA
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Credential | M.D.
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Telephone | 908-580-1025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 25MA03070600
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License Number State | NJ
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