Provider Demographics
NPI:1023484052
Name:CHANG, EUN HAE (MD)
Entity type:Individual
Prefix:
First Name:EUN
Middle Name:HAE
Last Name:CHANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 AVENUE AT THE CMN STE 8A
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:07702-4569
Mailing Address - Country:US
Mailing Address - Phone:732-868-8622
Mailing Address - Fax:732-862-8687
Practice Address - Street 1:180 AVENUE AT THE CMN STE 8A
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:NJ
Practice Address - Zip Code:07702-4569
Practice Address - Country:US
Practice Address - Phone:732-868-8622
Practice Address - Fax:732-862-8687
Is Sole Proprietor?:No
Enumeration Date:2015-08-13
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA10729500207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology