Provider Demographics
NPI:1851704084
Name:CHONG, UL SIK JASON (DOCTORATE OF PHARMAC)
Entity Type:Individual
Prefix:MR
First Name:UL SIK JASON
Middle Name:
Last Name:CHONG
Suffix:
Gender:M
Credentials:DOCTORATE OF PHARMAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 EAST TOWNSHIPLINE ROAD STE LL
Mailing Address - Street 2:
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083
Mailing Address - Country:US
Mailing Address - Phone:215-525-1100
Mailing Address - Fax:215-525-1101
Practice Address - Street 1:700 EAST TOWNSHIPLINE ROAD STE LL
Practice Address - Street 2:
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083
Practice Address - Country:US
Practice Address - Phone:215-525-1100
Practice Address - Fax:215-525-1101
Is Sole Proprietor?:No
Enumeration Date:2014-06-05
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP438049183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist