Provider Demographics
NPI:1003550476
Name:CHUGH, GEETANJALI
Entity Type:Individual
Prefix:
First Name:GEETANJALI
Middle Name:
Last Name:CHUGH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 ANDERSON AVE APT 21N
Mailing Address - Street 2:
Mailing Address - City:CLIFFSIDE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07010-2173
Mailing Address - Country:US
Mailing Address - Phone:646-341-7939
Mailing Address - Fax:
Practice Address - Street 1:345 E 80TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-0644
Practice Address - Country:US
Practice Address - Phone:646-341-7939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-22
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY092143-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker