Provider Demographics
NPI:1225091168
Name:CHAN, ARLINA MARIANO (MD)
Entity Type:Individual
Prefix:DR
First Name:ARLINA
Middle Name:MARIANO
Last Name:CHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MA. ARLINA
Other - Middle Name:MARIANO
Other - Last Name:BAETIONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:94 OLD SHORT HILLS RD STE 3234
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-5672
Mailing Address - Country:US
Mailing Address - Phone:973-322-5437
Mailing Address - Fax:973-322-8833
Practice Address - Street 1:94 OLD SHORT HILLS RD STE 3234
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-5672
Practice Address - Country:US
Practice Address - Phone:973-322-2631
Practice Address - Fax:973-322-8833
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA105221002080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ714593Medicaid