Provider Demographics
NPI:1851359962
Name:CHONG, CHRISTOPHER K (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:K
Last Name:CHONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 W JIMMIE LEEDS RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-9411
Mailing Address - Country:US
Mailing Address - Phone:609-652-3379
Mailing Address - Fax:609-652-2078
Practice Address - Street 1:76 W JIMMIE LEEDS RD
Practice Address - Street 2:SUITE 302
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-9411
Practice Address - Country:US
Practice Address - Phone:609-652-3379
Practice Address - Fax:609-652-2078
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-01
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03370000207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
P418390OtherOXFORD
F15837OtherPAS
0434928000OtherAMERIHEALTH
544544Medicare ID - Type Unspecified
P418390OtherOXFORD