Healthcare Provider Details

I. General information

NPI: 1295023521
Provider Name (Legal Business Name): WOOJIN CHONG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: WOOJIN CHONG-KAUFMAN M.D.

II. Dates (important events)

Enumeration Date: 07/20/2011
Last Update Date: 10/27/2021
Certification Date: 10/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2950 COLLEGE DRIVE SUITE 2A
VINELAND NJ
08360-6915
US

IV. Provider business mailing address

2950 COLLEGE DRIVE SUITE 2A
VINELAND NJ
08360-6915
US

V. Phone/Fax

Practice location:
  • Phone: 856-641-8680
  • Fax: 856-641-8679
Mailing address:
  • Phone: 856-641-8680
  • Fax: 856-641-8679

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number278519
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: