Provider Demographics
NPI:1790556421
Name:ENG FERRELL, CHUEN C
Entity Type:Individual
Prefix:
First Name:CHUEN
Middle Name:C
Last Name:ENG FERRELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 MEMPHIS AVE
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109-1911
Mailing Address - Country:US
Mailing Address - Phone:973-476-9561
Mailing Address - Fax:
Practice Address - Street 1:3 FARRINGTON ST
Practice Address - Street 2:
Practice Address - City:VAUXHALL
Practice Address - State:NJ
Practice Address - Zip Code:07088-1307
Practice Address - Country:US
Practice Address - Phone:973-762-4946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-11
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator