Healthcare Provider Details

I. General information

NPI: 1457121162
Provider Name (Legal Business Name): TRENASA N CHO-CHUN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2024
Last Update Date: 01/03/2024
Certification Date: 01/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 PROSPECT AVE
HACKENSACK NJ
07601-1915
US

IV. Provider business mailing address

73 SENECA AVE
DUMONT NJ
07628-2751
US

V. Phone/Fax

Practice location:
  • Phone: 551-996-2419
  • Fax:
Mailing address:
  • Phone: 347-528-1371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number147743
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: