Basic Information
| Provider Information | |||||||||
| NPI: | 1588985188 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHHEDA | ||||||||
| FirstName: | MONIQUE | ||||||||
| MiddleName: | KAMARIA | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 110 MARTER AVE | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | MOORESTOWN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080573124 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8562356565 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 110 MARTER AVE | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | MOORESTOWN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080573124 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8562356565 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/17/2010 | ||||||||
| LastUpdateDate: | 09/01/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | D77294 | MD | N | Allopathic & Osteopathic Physicians | Dermatology | 207N00000X | 25MA09744900 | NJ | Y | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.