Provider Demographics
NPI:1023454261
Name:DREAM PHYSICIANS
Entity type:Organization
Organization Name:DREAM PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHETANKUMAR
Authorized Official - Middle Name:KESHAVBHAI
Authorized Official - Last Name:CHAUHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-318-0756
Mailing Address - Street 1:23 MAIDA RD
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-2531
Mailing Address - Country:US
Mailing Address - Phone:732-318-0756
Mailing Address - Fax:856-212-1214
Practice Address - Street 1:1503 SAINT GEORGES AVE STE 106
Practice Address - Street 2:
Practice Address - City:COLONIA
Practice Address - State:NJ
Practice Address - Zip Code:07067-3427
Practice Address - Country:US
Practice Address - Phone:908-388-1716
Practice Address - Fax:856-212-1214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-15
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MA09202000OtherSTATE LICENSE