MEDICARE: SHEILA MARIE CHAPATWALA M.A., CCC-A,FAAA

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
1	231H00000X	Audiologist	41YA00029300	NJ

General Provider Information

NPI Number	:	1477726651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHEILA MARIE CHAPATWALA M.A., CCC-A,FAAA

Provider Business Mailing Address
First Line	:	25 INDIGO DR
Second Line	:	1A
City	:	OLD BRIDGE
State	:	NJ
Zip	:	08857-3591
Country	:	US
Telephone Number	:	732-234-6659
Fax Number	:

Provider Business Practice Location Address
First Line	:	470 NORTH AVE
Second Line	:
City	:	ELIZABETH
State	:	NJ
Zip	:	07208-1738
Country	:	US
Telephone Number	:	908-352-6700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2008
Last Update Date	:	04/08/2008

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