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General NPI Number Information
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NPI Number | 1962579466
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Entity Type | Individual
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Provider Name | SHOBHA A CHOTTERA MD
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Gender | Female
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3350 HIGHWAY 138 AUTUMN RIDGE OFFICE PARK BLD # 2 SUITE 128
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City | WALL
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State | NJ
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Zip | 07719
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Country | US
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Telephone | 732-280-8850
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Fax | 732-385-9753
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Provider Business Mailing Address
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Address Line | 3350 HIGHWAY 138 AUTUMN RIDGE OFFICE PARK BLD # 2 SUITE 128
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City | WALL
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State | NJ
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Zip | 07719
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Country | US
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Telephone | 732-280-8850
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Fax | 732-385-9753
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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 | MA057495
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License Number State | NJ
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