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General NPI Number Information
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NPI Number | 1578904959
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Entity Type | Individual
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Provider Name | CHAE UN CHONG RPH
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Gender | Female
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Dates
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Enumeration Date | 07/12/2013
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Last Update Date | 07/12/2013
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Provider Practice Location Address
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Address Line | 625 EVANS ST
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City | ELIZABETH
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State | NJ
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Zip | 07201-2008
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Country | US
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Telephone | 973-693-4380
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Fax | 973-693-4385
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Provider Business Mailing Address
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Address Line | 484 11TH ST
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City | CRESSKILL
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State | NJ
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Zip | 07626-1244
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Country | US
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Telephone | 202-210-1773
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Fax | 973-693-4380
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 28RI02268600
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License Number State | NJ
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