Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 25MB10209900 | NJ |
N | 207P00000X | Emergency Physician | OS014833 | PA |
NPI | 1003044884 |
---|---|
Provider Name | Rachel Eisenbrock Chase |
First Address | Camden, NJ 08103-1088 |
Second Address | Camden, NJ 08103-1461 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2009 |
Last Update Date | 15/01/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2113960 | PA BLUE SHIELD (01) | PA |