Healthcare Provider Details

I. General information

NPI: 1821399429
Provider Name (Legal Business Name): CHOU SOK TAING PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/12/2010
Last Update Date: 11/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 WHITEHORSE MERCERVILLE RD SUITE 212
HAMILTON NJ
08619-3835
US

IV. Provider business mailing address

1401 WHITEHORSE MERCERVILLE RD SUITE 212
HAMILTON NJ
08619-3835
US

V. Phone/Fax

Practice location:
  • Phone: 609-588-5081
  • Fax: 609-588-5086
Mailing address:
  • Phone: 609-588-5081
  • Fax: 609-588-5086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA054737
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: