Healthcare Provider Details

I. General information

NPI: 1821951013
Provider Name (Legal Business Name): MRS. ELIZABETH ANNE CHA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 WHITE HORSE PIKE STE 8
BARRINGTON NJ
08007-1322
US

IV. Provider business mailing address

71 HARTFORD RD
MEDFORD NJ
08055-9014
US

V. Phone/Fax

Practice location:
  • Phone: 856-474-2896
  • Fax:
Mailing address:
  • Phone: 609-321-2003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ15479500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: