Provider Demographics
NPI:1821499914
Name:CHAE ANESTHESIA ASSOCIATE, PC
Entity Type:Organization
Organization Name:CHAE ANESTHESIA ASSOCIATE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HUNG
Authorized Official - Middle Name:Y
Authorized Official - Last Name:CHAE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-607-9090
Mailing Address - Street 1:PO BOX 949
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-0949
Mailing Address - Country:US
Mailing Address - Phone:732-607-9090
Mailing Address - Fax:732-607-1160
Practice Address - Street 1:15301 NORTHERN BLVD APT 2D
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5038
Practice Address - Country:US
Practice Address - Phone:718-321-3210
Practice Address - Fax:732-607-1160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-09
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY181429-1305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG100031830Medicare UPIN