Provider Demographics
NPI:1871235911
Name:CHINNAPPA, MAAYA AJAY
Entity type:Individual
Prefix:
First Name:MAAYA
Middle Name:AJAY
Last Name:CHINNAPPA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ASHNA
Other - Middle Name:
Other - Last Name:CHINNAPPA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3526 JOHN F. KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07307
Mailing Address - Country:US
Mailing Address - Phone:201-653-5933
Mailing Address - Fax:
Practice Address - Street 1:3526 JOHN F. KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07307
Practice Address - Country:US
Practice Address - Phone:201-653-5933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-09
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
VA0116037013208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program