Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | MA65556 | NJ |
NPI | 1124071261 |
---|---|
Provider Name | John Asghar Chuback |
First Address | Paramus, NJ 07652-1424 |
Second Address | Paramus, NJ 07652-1424 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 13/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8915601 | (05) | NJ |
H59925 | (02) | NJ |