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General NPI Number Information
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NPI Number | 1992950232
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Entity Type | Individual
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Provider Name | JESSICA CHOW D.O.
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Gender | Female
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Dates
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Enumeration Date | 12/01/2008
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Last Update Date | 06/07/2018
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Provider Practice Location Address
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Address Line | 516 HAMBURG TPKE STE 5
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City | WAYNE
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State | NJ
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Zip | 07470
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Country | US
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Telephone | 973-925-7770
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Fax | 973-925-7772
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Provider Business Mailing Address
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Address Line | 516 HAMBURG TPKE STE 5
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City | WAYNE
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State | NJ
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Zip | 07470-2063
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Country | US
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Telephone | 973-925-7770
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Fax | 973-925-7772
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MB08815300
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License Number State | NJ
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