Provider Demographics
NPI:1134306905
Name:CHENITZ, KARA BETH (MD)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:BETH
Last Name:CHENITZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 CENTRAL AVE
Mailing Address - Street 2:BLDNG B, LEVEL 4
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07102-1909
Mailing Address - Country:US
Mailing Address - Phone:973-624-4908
Mailing Address - Fax:973-877-5595
Practice Address - Street 1:111 CENTRAL AVE
Practice Address - Street 2:BLDNG B, LEVEL 4
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-1909
Practice Address - Country:US
Practice Address - Phone:973-624-4908
Practice Address - Fax:973-877-5595
Is Sole Proprietor?:No
Enumeration Date:2008-01-23
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD445919207R00000X, 207RN0300X
NJ25MA0932410207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine