Provider Demographics
NPI:1629201595
Name:CHANDARANA, SHWETA
Entity Type:Individual
Prefix:MRS
First Name:SHWETA
Middle Name:
Last Name:CHANDARANA
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 1:22 SCHWEID CT
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-2739
Mailing Address - Country:US
Mailing Address - Phone:408-759-0377
Mailing Address - Fax:
Practice Address - Street 1:22 SCHWEID CT
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-2739
Practice Address - Country:US
Practice Address - Phone:408-759-0377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-26
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00491700225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist