Provider Demographics
NPI:1760441620
Name:CHAUDHARY, RITA B (PT)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:B
Last Name:CHAUDHARY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 BUCK RD
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-3906
Mailing Address - Country:US
Mailing Address - Phone:732-390-5544
Mailing Address - Fax:732-257-7016
Practice Address - Street 1:71 BRUNSWICK WOODS DR
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5601
Practice Address - Country:US
Practice Address - Phone:732-390-5544
Practice Address - Fax:732-257-7016
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00136300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ462074Medicare PIN