Healthcare Provider Details

I. General information

NPI: 1134947781
Provider Name (Legal Business Name): ANA J CHONG NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2024
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91 MAIN ST
PATERSON NJ
07505-1026
US

IV. Provider business mailing address

91 MAIN ST
PATERSON NJ
07505-1026
US

V. Phone/Fax

Practice location:
  • Phone: 973-523-1800
  • Fax: 973-689-3081
Mailing address:
  • Phone: 973-523-1800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAG10240010
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: