Healthcare Provider Details

I. General information

NPI: 1699797647
Provider Name (Legal Business Name): VA NJHCS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

385 TREMONT AVE DEPT. OF MEDICINE 111-ID
EAST ORANGE NJ
07018-1023
US

IV. Provider business mailing address

385 TREMONT AVE DEPT. OF MEDICINE 111-ID
EAST ORANGE NJ
07018-1023
US

V. Phone/Fax

Practice location:
  • Phone: 973-676-1000
  • Fax: 973-395-7085
Mailing address:
  • Phone: 973-676-1000
  • Fax: 973-395-7085

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number230410
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code261QV0200X
TaxonomyVA Clinic/Center
License Number230410
License Number StateNY

VIII. Authorized Official

Name: DR. TOM CHIANG
Title or Position: ATTENDING PHYSICIAN
Credential: MD
Phone: 973-676-1000