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1861079162
DAVIS CHACKO
NEWARK, NJ
NPI
1861079162
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2021-03-24
Last Update Date
2021-03-24
Business Address
DAVIS CHACKO
150 BERGEN ST
NEWARK, NJ 07103-2496
Phone number: 973-972-4300
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Mailing Address
DAVIS CHACKO
12525 KENNY DR
GRANADA HILLS, CA 91344-1838
Phone number: 818-987-1033
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