Provider Demographics
NPI:1295836351
Name:K. NEENA CHIMA, MD, LLC
Entity Type:Organization
Organization Name:K. NEENA CHIMA, MD, LLC
Other - Org Name:COREDERM DERMATOLOGY & COSMETIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:K. NEENA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-616-7117
Mailing Address - Street 1:246 HAMBURG TPKE
Mailing Address - Street 2:SUITE 306
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2156
Mailing Address - Country:US
Mailing Address - Phone:973-956-0500
Mailing Address - Fax:973-956-0522
Practice Address - Street 1:246 HAMBURG TPKE
Practice Address - Street 2:SUITE 306
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2156
Practice Address - Country:US
Practice Address - Phone:973-956-0500
Practice Address - Fax:973-956-0522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ107610OtherMEDICARE PTAN