Provider Demographics
NPI:1083981112
Name:UMDNJ-NEWARK
Entity Type:Organization
Organization Name:UMDNJ-NEWARK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ANESTHESIA RESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAITANYA
Authorized Official - Middle Name:K
Authorized Official - Last Name:CHALLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-736-3567
Mailing Address - Street 1:185 S ORANGE AVE
Mailing Address - Street 2:MSB-E547
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07103-2757
Mailing Address - Country:US
Mailing Address - Phone:973-972-0470
Mailing Address - Fax:973-972-0582
Practice Address - Street 1:185 S ORANGE AVE
Practice Address - Street 2:MSB-E547
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103-2757
Practice Address - Country:US
Practice Address - Phone:973-972-0470
Practice Address - Fax:973-972-0582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-17
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital