Provider Demographics
NPI:1689770042
Name:CHOMA, MYROSLAW (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:MYROSLAW
Middle Name:
Last Name:CHOMA
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:DR
Other - First Name:MYROSLAW
Other - Middle Name:
Other - Last Name:CHOMA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:2560 US HIGHWAY 22 # 226
Mailing Address - Street 2:
Mailing Address - City:SCOTCH PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07076-1529
Mailing Address - Country:US
Mailing Address - Phone:908-316-8330
Mailing Address - Fax:908-527-8550
Practice Address - Street 1:2560 US HIGHWAY 22 # 226
Practice Address - Street 2:
Practice Address - City:SCOTCH PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07076-1529
Practice Address - Country:US
Practice Address - Phone:908-316-8330
Practice Address - Fax:908-527-8550
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2014-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02865700207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF07191Medicare UPIN