Shobha A Chottera, MD
Individual provider Active NPI Psychiatry Physician · Wall, NJ
NPI 1962579466 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1962579466
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- MA057495 (NJ)
- Practice address
- 3350 Highway 138
Autumn Ridge Office Park BLD # 2 Suite 128
Wall, NJ 07719 - Phone
- (732) 280-8850
- Fax
- (732) 385-9753
- NPI assigned
- Nov 29, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA057495 | NJ | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jersey Shore Psychiatric Associates, P.C. | Psychiatry | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MA057495 | NJ | Yes |
Addresses
Primary practice location
3350 Highway 138
Autumn Ridge Office Park BLD # 2 Suite 128
Wall, NJ 07719
Mailing address
3350 Highway 138
Autumn Ridge Office Park BLD # 2 Suite 128
Wall, NJ 07719
Phone (732) 280-8850
Other providers in Wall, NJ
- Care One at Wall, LLC
- Carisk Specialty Services, LLC
- Alan A Cavaiola
- Augusto Caesar Cespedes Jr.
- Tiffany Cherry
- Christina Marie Cognetti
- Domenico Colletti Jr.
- Complete Care by BDM, LLC
- Michael Cosulich
- Crean Counseling LLC
All providers in Wall, NJ · Psychiatry Physician in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.