Provider Demographics
NPI:1770507113
Name:CHORDIA-KHAN, KANCHAN (DPT)
Entity Type:Individual
Prefix:
First Name:KANCHAN
Middle Name:
Last Name:CHORDIA-KHAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1323 STATE ROUTE 34
Mailing Address - Street 2:STE A
Mailing Address - City:ABERDEEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-1955
Mailing Address - Country:US
Mailing Address - Phone:908-358-7028
Mailing Address - Fax:
Practice Address - Street 1:1323 ROUTE 34
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:NJ
Practice Address - Zip Code:07747
Practice Address - Country:US
Practice Address - Phone:908-358-7028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00437900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist