Provider Demographics
NPI:1568631026
Name:CHHODA, NITIN (PT)
Entity type:Individual
Prefix:MR
First Name:NITIN
Middle Name:
Last Name:CHHODA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 PROSPECT AVE
Mailing Address - Street 2:225
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-2511
Mailing Address - Country:US
Mailing Address - Phone:201-723-7149
Mailing Address - Fax:952-674-3057
Practice Address - Street 1:240 PROSPECT AVE
Practice Address - Street 2:225
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-2511
Practice Address - Country:US
Practice Address - Phone:201-723-7149
Practice Address - Fax:952-674-3057
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-28
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01256200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist