Provider Demographics
NPI:1679661060
Name:CHAWDA, KHIMRAJ KANJI (OCCUPATIONAL THERAPI)
Entity type:Individual
Prefix:MR
First Name:KHIMRAJ
Middle Name:KANJI
Last Name:CHAWDA
Suffix:
Gender:M
Credentials:OCCUPATIONAL THERAPI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1475 IROQUOIS CT S
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-4080
Mailing Address - Country:US
Mailing Address - Phone:732-818-9463
Mailing Address - Fax:732-818-1374
Practice Address - Street 1:1475 IROQUOIS CT S
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-4080
Practice Address - Country:US
Practice Address - Phone:732-818-9463
Practice Address - Fax:732-818-1374
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR000555225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist