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NPI Code Detail

MEDICARE: KOKILA CHANDARANA, M.D; PA

MEDICARE: KOKILA CHANDARANA, M.D; PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208100000XPhysical Medicine & Rehabilitation Physician25MA03070600NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275700809
Entity Type Code : Organization
Provider Name (Legal Business Name) : KOKILA CHANDARANA, M.D; PA
Provider Business Mailing Address
First Line : 24 NOTTINGHAM WAY
Second Line :
City : WARREN
State : NJ
Zip : 07059-6753
Country : US
Telephone Number : 908-580-1025
Fax Number : 908-548-0849
Provider Business Practice Location Address
First Line : 140 PARK AVE
Second Line : WINDSOR GARDEN CARE CENTER
City : EAST ORANGE
State : NJ
Zip : 07017-5248
Country : US
Telephone Number : 973-677-1500
Fax Number : 973-675-0512
Authorized Official
Title or Position : PRESIDENT
Name : DR. KOKILA SHASHIKANT CHANDARANA
Credential : M.D.
Telephone Number : 908-580-1025
Provider Enumeration Date : 05/13/2008
Last Update Date : 05/13/2008

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