Provider Demographics
NPI:1134156367
Name:CHIN, CHIK S (MD)
Entity type:Individual
Prefix:
First Name:CHIK
Middle Name:S
Last Name:CHIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:306 REYNA PL
Mailing Address - Street 2:
Mailing Address - City:BRANCHBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08853-4038
Mailing Address - Country:US
Mailing Address - Phone:908-730-5703
Mailing Address - Fax:908-730-1340
Practice Address - Street 1:HUNTERDON DEVELOPMENTAL CENTER
Practice Address - Street 2:40 PITTSTOWN RD
Practice Address - City:CLINTON
Practice Address - State:NJ
Practice Address - Zip Code:08809-4003
Practice Address - Country:US
Practice Address - Phone:908-730-5703
Practice Address - Fax:908-730-1340
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA35144207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0541702Medicaid
NJ443788B1LOtherMEDICARE BILLING NO.
NJC54659Medicare UPIN