Provider Demographics
NPI:1497933030
Name:CHAU KAI KONG DPM
Entity Type:Organization
Organization Name:CHAU KAI KONG DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAU KAI
Authorized Official - Middle Name:
Authorized Official - Last Name:KONG
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:908-874-7592
Mailing Address - Street 1:301 OMNI DR
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-4526
Mailing Address - Country:US
Mailing Address - Phone:908-874-7592
Mailing Address - Fax:908-281-5533
Practice Address - Street 1:301 OMNI DR
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-4526
Practice Address - Country:US
Practice Address - Phone:908-874-7592
Practice Address - Fax:908-281-5533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00127000332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0678220001Medicare NSC