1710378153 NPI number — MRS. CRISTINA SOFIA CHONKO NP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710378153 NPI number — MRS. CRISTINA SOFIA CHONKO NP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHONKO
Provider First Name:
CRISTINA
Provider Middle Name:
SOFIA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
NP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ALMEIDA
Provider Other First Name:
CRISTINA
Provider Other Middle Name:
SOFIA
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1710378153
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/13/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
727 NORTH BEERS STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOLMDEL
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07733
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-497-1836
Provider Business Mailing Address Fax Number:
848-245-8414

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
727 NORTH BEERS STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOLMDEL
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07733
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-497-1836
Provider Business Practice Location Address Fax Number:
848-245-8414
Provider Enumeration Date:
02/06/2015

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 364SG0600X , with the licence number:  26NJ00538900 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 26NL00538900 . This is a "APN ADULT GERONTOLOGY DISTRESS" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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