Provider Demographics
NPI:1366657876
Name:CHIODO, PAUL G (MS, OTR L)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:G
Last Name:CHIODO
Suffix:
Gender:M
Credentials:MS, OTR L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 LEHIGH ST
Mailing Address - Street 2:
Mailing Address - City:WHARTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07885-2508
Mailing Address - Country:US
Mailing Address - Phone:973-216-3656
Mailing Address - Fax:
Practice Address - Street 1:151 RT. 10 EAST
Practice Address - Street 2:SUITE 201
Practice Address - City:SUCCASUNNA
Practice Address - State:NJ
Practice Address - Zip Code:07876
Practice Address - Country:US
Practice Address - Phone:973-252-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00357800174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist