Basic Information
| Provider Information | |||||||||
| NPI: | 1013351675 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHHABRA | ||||||||
| FirstName: | NATASHA | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1130 MCBRIDE AVENUE | ||||||||
| Address2: | 3RD FLOOR | ||||||||
| City: | WOODLAND PARK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07424 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9737852277 | ||||||||
| FaxNumber: | 9738121404 | ||||||||
| Practice Location | |||||||||
| Address1: | 1031 MCBRIDE AVENUE | ||||||||
| Address2: | SUITE D212 | ||||||||
| City: | WOODLAND PARK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07424 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9736208500 | ||||||||
| FaxNumber: | 9738905609 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/24/2013 | ||||||||
| LastUpdateDate: | 04/01/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/01/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | 25MA10525000 | NJ | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
ID Information
| ID | Type | State | Issuer | Description | 0682977 | 05 | NJ | MEDICAID |