Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 35-093271 | OH |
N | 208000000X | Pediatrician | 57.011565 | OH |
N | 208000000X | Pediatrician | 60-255795 | NY |
Y | 2080P0202X | Pediatric Cardiologist | 25MA09254800 | NJ |
NPI | 1235344110 |
---|---|
Provider Name | Mrs. Stephanie E Chin |
First Address | Shrewsbury, NJ 07702-4054 |
Second Address | Brick, NJ 08724-3048 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2007 |
Last Update Date | 03/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2951202 | (05) | OH |