Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 25MA10729500 | NJ |
NPI | 1023484052 |
---|---|
Provider Name | Eun Hae Chang |
First Address | Shrewsbury, NJ 07702-4334 |
Second Address | Shrewsbury, NJ 07702-4334 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2015 |
Last Update Date | 30/07/2020 |