Provider Demographics
NPI:1548531502
Name:CHIODO, DAMIEN F (MD)
Entity type:Individual
Prefix:DR
First Name:DAMIEN
Middle Name:F
Last Name:CHIODO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:48 LEHIGH ST
Mailing Address - Street 2:
Mailing Address - City:WHARTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07885-2508
Mailing Address - Country:US
Mailing Address - Phone:973-722-5439
Mailing Address - Fax:
Practice Address - Street 1:547 E BROAD ST FL 2
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-2107
Practice Address - Country:US
Practice Address - Phone:908-264-2454
Practice Address - Fax:908-603-8794
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-23
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA090462002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry