Provider Demographics
NPI:1932197456
Name:CHAWLA, RAJNISH (MD)
Entity Type:Individual
Prefix:
First Name:RAJNISH
Middle Name:
Last Name:CHAWLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1545 HARBOURTON ROCKTOWN RD
Mailing Address - Street 2:
Mailing Address - City:LAMBERTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08530-3003
Mailing Address - Country:US
Mailing Address - Phone:609-890-4200
Mailing Address - Fax:609-586-0399
Practice Address - Street 1:3840 QUAKERBRIDGE RD
Practice Address - Street 2:BLDG 2, SUITE 110
Practice Address - City:MERCERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08619-1003
Practice Address - Country:US
Practice Address - Phone:609-890-4200
Practice Address - Fax:609-586-0399
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07620800207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0220132Medicaid
696800Medicare ID - Type Unspecified
NJ0220132Medicaid
NJ078152ZFYBMedicare PIN