Cheatam, Consetta Mae
Cheatam, Consetta Mae is an individual health care provider with primary practice located at 22 Sylvan St Ste 300 , Rutherford NJ 07070-2069. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Cheatam, Consetta Mae can be contacted via phone (201) 438-8860.Contact Information
Primary practice address
22 Sylvan St Ste 300
Rutherford NJ 07070-2069
Phone: (201) 438-8860
Fax: (201) 438-1994
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | MA070577 | New Jersey |
Profile Details
| NPI number | 1619989860 |
|---|---|
| LBN Legal business name | Cheatam, Consetta Mae |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 13th, 2006 |
| Last updated | Jun 25th, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619989860 | NPPES |
| New Jersey | MEDICAID | 8271500 |
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