Provider Demographics
NPI:1841219953
Name:CHOKHAVATIA, SITA S (MD)
Entity Type:Individual
Prefix:
First Name:SITA
Middle Name:S
Last Name:CHOKHAVATIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 PATERSON STREET ROBERT WOOD JOHNSON MEDICAL GROUP
Mailing Address - Street 2:CLINICAL ACADEMIC BUILDING
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:09801
Mailing Address - Country:US
Mailing Address - Phone:732-235-7784
Mailing Address - Fax:732-235-7792
Practice Address - Street 1:125 PATERSON ST ROBERT WOOD JOHNSON MEDICAL GROUP
Practice Address - Street 2:CLINICAL ACADEMIC BUILDING
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:09801
Practice Address - Country:US
Practice Address - Phone:732-235-7784
Practice Address - Fax:732-235-7792
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ042969207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
62K182Medicare ID - Type Unspecified
B21846Medicare UPIN