| Radhika Chinai, Llc | |
|
610 Washington Boulevard Jersey City NJ 07310 | |
| (201) 222-1266 | |
| (201) 626-4548 |
| Full Name | Radhika Chinai, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 610 Washington Boulevard, Jersey City, New Jersey |
| Authorized Official Name and Position | Ronak Chinai (OPERATING MANAGER) |
| Authorized Official Contact | 2012221266 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Radhika Chinai, Llc 49 Melrose Dr Livingston NJ 07039-2454 Ph: (201) 222-1266 | Radhika Chinai, Llc 610 Washington Boulevard Jersey City NJ 07310 Ph: (201) 222-1266 |
| NPI Number | 1346259306 |
|---|---|
| Provider Enumeration Date | 08/07/2006 |
| Last Update Date | 10/16/2007 |
| Medicare PECOS PAC ID | 1355309998 |
|---|---|
| Medicare Enrollment ID | O20041229000131 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346259306 | NPI | - | NPPES |
| 0045691 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 25MA07740500 (New Jersey) | Primary |
| Provider Name | Ronak N Chinai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235115312 PECOS PAC ID: 1254399892 Enrollment ID: I20041229000169 |
| Provider Name | Eman Zedan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861929101 PECOS PAC ID: 2769749811 Enrollment ID: I20171128003729 |
| Provider Name | Tiffany Renae Wade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225520505 PECOS PAC ID: 6406103316 Enrollment ID: I20191014000152 |
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