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NPI Code Detail

MEDICARE: ANNA CHUNG PA-C

MEDICARE: ANNA CHUNG PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant25MP00094300NJ

General Provider Information

NPI Number : 1053535880
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNA CHUNG PA-C
Provider Business Mailing Address
First Line : 402 LIPPINCOTT DR
Second Line :
City : MARLTON
State : NJ
Zip : 08053-4112
Country : US
Telephone Number : 856-782-3300
Fax Number : 856-504-8029
Provider Business Practice Location Address
First Line : 170 CHANGEBRIDGE RD BLDG C3
Second Line :
City : MONTVILLE
State : NJ
Zip : 07045-9112
Country : US
Telephone Number : 973-575-5540
Fax Number : 973-575-4885
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2007
Last Update Date : 02/28/2023

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Directions to “ ANNA CHUNG PA-C” Practice Location

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