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General NPI Number Information
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NPI Number | 1679003883
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Entity Type | Individual
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Provider Name | JOSEPH CHORBA JR. LICENSED PROSTHETIST
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Gender | Male
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Dates
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Enumeration Date | 06/20/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 163 ROUTE 130 BUILDING 2 SUITE D
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City | BORDENTOWN
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State | NJ
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Zip | 08505
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Country | US
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Telephone | 609-379-6453
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Fax | 609-379-6754
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Provider Business Mailing Address
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Address Line | 234 WASHINGTON ST
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City | FIELDSBORO
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State | NJ
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Zip | 08505-1143
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Country | US
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Telephone | 609-649-4158
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Fax |
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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 | 224900000X
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Taxonomy Name | Mastectomy Fitter
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License Number | 45PO00006900
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License Number State |
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Taxonomy #2
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | 45PO00006900
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License Number State | NJ
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