Provider Demographics
NPI:1568425601
Name:SANG-URAI, CHINTANA (MD)
Entity Type:Individual
Prefix:DR
First Name:CHINTANA
Middle Name:
Last Name:SANG-URAI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 W GILBERT ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-4947
Mailing Address - Country:US
Mailing Address - Phone:732-212-0060
Mailing Address - Fax:
Practice Address - Street 1:530 NEW BRUNSWICK AVE
Practice Address - Street 2:
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-3674
Practice Address - Country:US
Practice Address - Phone:732-442-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03088800207P00000X
PAMD035501L207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA85808OtherGEISINGER
PA2516347OtherGHI
PAP00130325OtherRAILROAD MEDICARE
NJ2420201Medicaid
PA818764OtherFIRST PRIORITY HEALTH
PA000926778OtherHIGHMARK BLUE SHIELD
PA001840040Medicaid
PA02729633OtherNEW YORK MEDICAID
NJP00105057OtherRAILROAD MEDICARE
NJ047158NUTMedicare PIN
PA001840040Medicaid
NJP00105057OtherRAILROAD MEDICARE
PA85808OtherGEISINGER
PA818764OtherFIRST PRIORITY HEALTH
NJ453812Medicare ID - Type Unspecified
NJ453812XZMMedicare PIN