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NPI Code Detail

MEDICARE: DR. JAE M CHU M.D.

MEDICARE: DR. JAE M CHU M.D.
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
1208D00000XGeneral Practice PhysicianNJ

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1609134B1GOTHERNJMEDICARE BILLING NO.

General Provider Information

NPI Number : 1902992357
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAE M CHU M.D.
Provider Business Mailing Address
First Line : 1175 DEHIRSCH AVE
Second Line :
City : WOODBINE
State : NJ
Zip : 08270-2401
Country : US
Telephone Number : 609-861-2164
Fax Number : 609-861-5771
Provider Business Practice Location Address
First Line : 1175 DEHIRSCH AVE
Second Line :
City : WOODBINE
State : NJ
Zip : 08270-2401
Country : US
Telephone Number : 609-861-2164
Fax Number : 609-861-5771
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2006
Last Update Date : 01/09/2008

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