Healthcare Provider Details

I. General information

NPI: 1801901202
Provider Name (Legal Business Name): CHEN YA HUANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JACOB CHEN YA HUANG M.D.

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 07/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 HIGHWAY 206
FLANDERS NJ
07836-9082
US

IV. Provider business mailing address

270 ROUTE 206, BARTLEY SQUARE
FLANDERS NJ
07836
US

V. Phone/Fax

Practice location:
  • Phone: 973-584-0233
  • Fax: 973-584-0037
Mailing address:
  • Phone: 973-584-0233
  • Fax: 973-584-0037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MA02822400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: