Provider Demographics
NPI:1649352857
Name:CHEETI, KALPANA (MD)
Entity type:Individual
Prefix:DR
First Name:KALPANA
Middle Name:
Last Name:CHEETI
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 1:15 ANDERSON ST
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-4508
Mailing Address - Country:US
Mailing Address - Phone:201-487-3355
Mailing Address - Fax:201-487-0960
Practice Address - Street 1:15 ANDERSON ST
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-4508
Practice Address - Country:US
Practice Address - Phone:201-487-3355
Practice Address - Fax:201-487-0960
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07441900207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJH67754Medicare UPIN
NJ060438XYUMedicare PIN