Provider Demographics
NPI:1679003883
Name:CHORBA, JOSEPH JR (LICENSED PROSTHETIST)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:CHORBA
Suffix:JR
Gender:M
Credentials:LICENSED PROSTHETIST
Other - Prefix:
Other - First Name:JOSEPH
Other - Middle Name:
Other - Last Name:CHORBA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LICENSED PROTHETIST
Mailing Address - Street 1:234 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:FIELDSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08505-1143
Mailing Address - Country:US
Mailing Address - Phone:609-649-4158
Mailing Address - Fax:
Practice Address - Street 1:163 ROUTE 130 BUILDING 2
Practice Address - Street 2:SUITE D
Practice Address - City:BORDENTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08505
Practice Address - Country:US
Practice Address - Phone:609-379-6453
Practice Address - Fax:609-379-6754
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
45PO00006900224900000X
NJ45PO00006900335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes335E00000XSuppliersProsthetic/Orthotic SupplierGroup - Multi-Specialty
No224900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMastectomy FitterGroup - Multi-Specialty