MEDICARE: CHESTER MEDICAL ASSOCIATES A PROFESSIONAL ASSOCIATION

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
1	207R00000X	Internal Medicine Physician	MA36221	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	CM4090	OTHER	RAILROAD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760539548
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHESTER MEDICAL ASSOCIATES A PROFESSIONAL ASSOCIATION

Provider Business Mailing Address
First Line	:	PO BOX 634
Second Line	:
City	:	CHESTER
State	:	NJ
Zip	:	07930-0634
Country	:	US
Telephone Number	:	908-879-6277
Fax Number	:	908-879-4464

Provider Business Practice Location Address
First Line	:	385 STATE ROUTE 24
Second Line	:	SUITE 1C
City	:	CHESTER
State	:	NJ
Zip	:	07930-2918
Country	:	US
Telephone Number	:	908-879-6277
Fax Number	:	908-879-4464

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ALAN H CHANIN
Credential	:	M.D.
Telephone Number	:	908-879-6277

Provider Enumeration Date	:	01/04/2007
Last Update Date	:	07/28/2010

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Directions to “CHESTER MEDICAL ASSOCIATES A PROFESSIONAL ASSOCIATION ” Practice Location

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