Provider Demographics
NPI:1245320944
Name:CHANSKY, MICHAEL E (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:E
Last Name:CHANSKY
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 1:1 FEDERAL ST # 200
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1088
Mailing Address - Country:US
Mailing Address - Phone:856-356-4924
Mailing Address - Fax:
Practice Address - Street 1:1 COOPER PLZ
Practice Address - Street 2:COOPER UNIVERISTY EMERGENCY PHYSICIANS
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1461
Practice Address - Country:US
Practice Address - Phone:856-342-2351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA42283207P00000X, 207R00000X
NJ25MA04228300207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0206903Medicaid
NJ3551666OtherAETNA
NJ588058OtherAMERIHEALTH PPO/PA BS
NJ010006252 00OtherAMERIHCHOICE
NJ18817OtherUNIVERISTY HEALTH PLAN
NJ0176323OtherCIGNA
NJ0409977000OtherAMERIHEALTH/KEYSTONE/IBC
NJ60005766OtherHORIZON NJ HEALTH
NJ588058OtherAMERIHEALTH PPO/PA BS
NJ0409977000OtherAMERIHEALTH/KEYSTONE/IBC
NJ588058 SZFMedicare PIN