Provider Demographics
NPI:1225044654
Name:CHIN, CHRISTINA W (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:W
Last Name:CHIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:WING-YU
Other - Last Name:CHUI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:100 TOWN CENTER DR
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07059-5692
Mailing Address - Country:US
Mailing Address - Phone:908-222-2777
Mailing Address - Fax:
Practice Address - Street 1:100 TOWN CENTER DR
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-5692
Practice Address - Country:US
Practice Address - Phone:908-222-2777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06520100207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7789301Medicaid
NJ090957A01Medicare PIN
NJ7789301Medicaid