Provider Demographics
NPI:1376692889
Name:CHELDER, MARK J (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:J
Last Name:CHELDER
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Gender:M
Credentials:PHD
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Mailing Address - Street 1:325 E JIMMIE LEEDS RD
Mailing Address - Street 2:#119
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-4126
Mailing Address - Country:US
Mailing Address - Phone:800-783-7930
Mailing Address - Fax:800-783-7930
Practice Address - Street 1:28 S NEW YORK RD
Practice Address - Street 2:SUITE B-5
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-9695
Practice Address - Country:US
Practice Address - Phone:800-783-7930
Practice Address - Fax:800-783-7930
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2014-05-19
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Provider Licenses
StateLicense IDTaxonomies
NJSI 03735103G00000X
PAPS-005007-L103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist