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General NPI Number Information
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NPI Number | 1396372587
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Entity Type | Individual
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Provider Name | BIANCA CHENDRIMADA DO
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Gender | Female
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Dates
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Enumeration Date | 03/26/2020
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Last Update Date | 05/25/2023
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Provider Practice Location Address
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Address Line | 780 US-3 WEST
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City | CLIFTON
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State | NJ
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Zip | 07012
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Country | US
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Telephone | 973-777-6767
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Fax |
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Provider Business Mailing Address
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Address Line | 106 KNOB HILL RD
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City | MORGANVILLE
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State | NJ
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Zip | 07751-9515
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Country | US
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Telephone | 732-330-2034
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 25MB11876600
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License Number State | NJ
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