Provider Demographics
NPI:1497794861
Name:CHIMA, KULJIT (MD)
Entity Type:Individual
Prefix:DR
First Name:KULJIT
Middle Name:
Last Name:CHIMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:K. NEENA
Other - Middle Name:
Other - Last Name:CHIMA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:246 HAMBURG TPKE
Mailing Address - Street 2:SUITE 306
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2156
Mailing Address - Country:US
Mailing Address - Phone:973-956-0500
Mailing Address - Fax:973-956-0522
Practice Address - Street 1:246 HAMBURG TPKE
Practice Address - Street 2:SUITE 306
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2156
Practice Address - Country:US
Practice Address - Phone:973-956-0500
Practice Address - Fax:973-956-0522
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-04
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07095000207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ044782OtherMEDICARE - PTAN