MEDICARE: NISHA P CHHABRIA MD

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	2084N0400X	Neurology Physician	MD038799	DC
2	390200000X	Student in an Organized Health Care Education/Training Program
3	2084N0400X	Neurology Physician	MD.205155	LA

Other Identifiers

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

General Provider Information

NPI Number	:	1952421398
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NISHA P CHHABRIA MD

Provider Business Mailing Address
First Line	:	4631 NORTH CONGRESS AVE
Second Line	:	SUITE 200
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-3234
Country	:	US
Telephone Number	:	561-845-0500
Fax Number	:	561-296-1101

Provider Business Practice Location Address
First Line	:	4631 NORTH CONGRESS AVE
Second Line	:	SUITE 200
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-3234
Country	:	US
Telephone Number	:	561-845-0500
Fax Number	:	561-296-1101

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

Provider Enumeration Date	:	03/30/2007
Last Update Date	:	08/05/2020

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Directions to “ NISHA P CHHABRIA MD” Practice Location

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