Provider Demographics
NPI:1568526382
Name:YIM, CHAE
Entity Type:Individual
Prefix:MR
First Name:CHAE
Middle Name:
Last Name:YIM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1207
Mailing Address - Country:US
Mailing Address - Phone:856-541-8989
Mailing Address - Fax:856-365-0168
Practice Address - Street 1:217 S BROADWAY
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1207
Practice Address - Country:US
Practice Address - Phone:856-541-8989
Practice Address - Fax:856-365-0168
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies