Provider Demographics
NPI:1962579466
Name:CHOTTERA, SHOBHA A (MD)
Entity type:Individual
Prefix:
First Name:SHOBHA
Middle Name:A
Last Name:CHOTTERA
Suffix:
Gender:F
Credentials:MD
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Other - Last Name:
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Mailing Address - Street 1:3350 HIGHWAY 138
Mailing Address - Street 2:AUTUMN RIDGE OFFICE PARK BLD # 2 SUITE 128
Mailing Address - City:WALL
Mailing Address - State:NJ
Mailing Address - Zip Code:07719
Mailing Address - Country:US
Mailing Address - Phone:732-280-8850
Mailing Address - Fax:732-385-9753
Practice Address - Street 1:3350 HIGHWAY 138
Practice Address - Street 2:AUTUMN RIDGE OFFICE PARK BLD # 2 SUITE 128
Practice Address - City:WALL
Practice Address - State:NJ
Practice Address - Zip Code:07719
Practice Address - Country:US
Practice Address - Phone:732-280-8850
Practice Address - Fax:732-385-9753
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA0574952084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry