Individual
DR. CHITRA KODERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
230 E RIDGEWOOD AVE, PARAMUS, NJ 07652
(201) 967-4000
(201) 967-4117
Mailing address
30 BERGEN ST RM 1205, NEWARK, NJ 07107-3000
(973) 972-0037
(973) 972-0743
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS018504
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0638951
—
NJ
Enumeration date
06/20/2012
Last updated
10/11/2018
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