Provider Demographics
NPI:1992866222
Name:KUO, CHEN-JEN (MD)
Entity Type:Individual
Prefix:
First Name:CHEN-JEN
Middle Name:
Last Name:KUO
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 1:25B VREELAND RD
Mailing Address - Street 2:PO BOX 0037
Mailing Address - City:FLORHAM PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07932-1900
Mailing Address - Country:US
Mailing Address - Phone:973-660-9334
Mailing Address - Fax:973-660-9732
Practice Address - Street 1:25B VREELAND RD
Practice Address - Street 2:
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-1900
Practice Address - Country:US
Practice Address - Phone:973-660-9334
Practice Address - Fax:973-660-9732
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA02776300207LP3000X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1787802Medicaid
NJ1787802Medicaid
NJ151190CNKMedicare PIN