Provider Demographics
NPI:1497099527
Name:GONZALEZ-CHAVARRIA, NILDA L
Entity Type:Individual
Prefix:
First Name:NILDA
Middle Name:L
Last Name:GONZALEZ-CHAVARRIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 HEMLOCK RD
Mailing Address - Street 2:
Mailing Address - City:BYRAM TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:07821-4024
Mailing Address - Country:US
Mailing Address - Phone:973-525-3755
Mailing Address - Fax:
Practice Address - Street 1:169 HALSEY RD
Practice Address - Street 2:SUITE #2
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054
Practice Address - Country:US
Practice Address - Phone:973-525-3755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00262700235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist