Provider Demographics
NPI:1346259306
Name:RADHIKA CHINAI, LLC
Entity Type:Organization
Organization Name:RADHIKA CHINAI, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATING MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONAK
Authorized Official - Middle Name:
Authorized Official - Last Name:CHINAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-222-1266
Mailing Address - Street 1:49 MELROSE DR
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-2454
Mailing Address - Country:US
Mailing Address - Phone:201-222-1266
Mailing Address - Fax:201-626-6548
Practice Address - Street 1:610 WASHINGTON BOULEVARD
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07310
Practice Address - Country:US
Practice Address - Phone:201-222-1266
Practice Address - Fax:201-626-4548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-07
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07740500207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0045691Medicaid
NJIZ3028Medicare UPIN
NJ086744Medicare PIN