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General NPI Number Information
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NPI Number | 1306247200
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Entity Type | Organization
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Legal Business Name | HUNG Y CHAE MDPA
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Dates
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Enumeration Date | 09/10/2014
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Last Update Date | 09/10/2014
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Provider Practice Location Address
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Address Line | 400 SYLVAN AVE STE 103
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City | ENGLEWOOD CLIFFS
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State | NJ
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Zip | 07632-2717
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Country | US
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Telephone | 732-607-9090
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Fax | 732-607-1160
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Provider Business Mailing Address
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Address Line | PO BOX 949
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City | FORT LEE
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State | NJ
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Zip | 07024-0949
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Country | US
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Telephone | 732-607-9090
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Fax | 732-607-1160
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Authorized Official
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Title or Position | PRESIDENT
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Name | HUNG Y CHAE
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Credential |
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Telephone | 732-607-9090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 25MA04523900
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License Number State | NJ
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