Provider Demographics
NPI:1710297023
Name:MAISURIA, CHHAYA NANU (PSYD)
Entity Type:Individual
Prefix:
First Name:CHHAYA
Middle Name:NANU
Last Name:MAISURIA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 BRIDGE PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-1746
Mailing Address - Country:US
Mailing Address - Phone:732-252-8556
Mailing Address - Fax:
Practice Address - Street 1:4 BRIDGE PLAZA DR
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-1746
Practice Address - Country:US
Practice Address - Phone:732-252-8556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-20
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018833-1103TC0700X
NJ35SI00509300103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical