Provider Demographics
NPI:1205970340
Name:CHAWLA, NATASHA RANI (OD)
Entity type:Individual
Prefix:DR
First Name:NATASHA
Middle Name:RANI
Last Name:CHAWLA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:415 STATE ROUTE 18
Mailing Address - Street 2:VILLAGE GREEN SHP. CTR.
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-2305
Mailing Address - Country:US
Mailing Address - Phone:732-238-7373
Mailing Address - Fax:732-238-5506
Practice Address - Street 1:415 STATE ROUTE 18
Practice Address - Street 2:VILLAGE GREEN SHP. CTR.
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-2305
Practice Address - Country:US
Practice Address - Phone:732-238-7373
Practice Address - Fax:732-238-5506
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJOA-05308152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist