Provider Demographics
NPI:1669027470
Name:CHHEDA, JILESH
Entity Type:Individual
Prefix:
First Name:JILESH
Middle Name:
Last Name:CHHEDA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 SYCAMORE AVE
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-4723
Mailing Address - Country:US
Mailing Address - Phone:973-803-0901
Mailing Address - Fax:973-808-1991
Practice Address - Street 1:70 S ORANGE AVE STE 105
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-4916
Practice Address - Country:US
Practice Address - Phone:973-803-0901
Practice Address - Fax:973-808-1991
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-08
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0291900251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health