Provider Demographics
NPI:1326389792
Name:JEYAMOHAN, CHANDRIKA C (APN-C)
Entity Type:Individual
Prefix:
First Name:CHANDRIKA
Middle Name:C
Last Name:JEYAMOHAN
Suffix:
Gender:F
Credentials:APN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 VAN DYKE RD
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-3642
Mailing Address - Country:US
Mailing Address - Phone:609-575-3702
Mailing Address - Fax:609-651-8357
Practice Address - Street 1:195 LITTLE ALBANY ST
Practice Address - Street 2:1124
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-1914
Practice Address - Country:US
Practice Address - Phone:732-235-9645
Practice Address - Fax:732-235-3299
Is Sole Proprietor?:No
Enumeration Date:2013-03-11
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00291400363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health