Basic Information
| Provider Information | |||||||||
| NPI: | 1477627750 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHIARAMIDA | ||||||||
| FirstName: | ANTHONY | ||||||||
| MiddleName: | JOSEPH | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 79 | ||||||||
| Address2: | |||||||||
| City: | BAYONNE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070020079 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2013391700 | ||||||||
| FaxNumber: | 2013396972 | ||||||||
| Practice Location | |||||||||
| Address1: | 530 NEW BRUNSWICK AVE | ||||||||
| Address2: | |||||||||
| City: | PERTH AMBOY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 08861 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7324423700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/20/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | MA42221 | NJ | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RC0000X | 1409561 | NY | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 5231604 | 05 | NJ | MEDICAID |