Healthcare Provider Details

I. General information

NPI: 1699240796
Provider Name (Legal Business Name): JOSEPH CHIONG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2018
Last Update Date: 05/14/2024
Certification Date: 05/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

932 S MAIN ST
PLEASANTVILLE NJ
08232-3646
US

IV. Provider business mailing address

317 CHATHAM DR
WILLIAMSTOWN NJ
08094-8847
US

V. Phone/Fax

Practice location:
  • Phone: 609-383-0880
  • Fax: 609-383-0658
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ00864700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: