Healthcare Provider Details

I. General information

NPI: 1841052206
Provider Name (Legal Business Name): JESSICA CHASE PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2024
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 BRUNSWICK AVE
TRENTON NJ
08638-4143
US

IV. Provider business mailing address

750 BRUNSWICK AVE
TRENTON NJ
08638-4143
US

V. Phone/Fax

Practice location:
  • Phone: 609-394-6000
  • Fax:
Mailing address:
  • Phone: 609-394-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number25MP00832500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: