Provider Demographics
NPI:1265616908
Name:CHANGCHIEN, CHARLIE JIJER (MD)
Entity type:Individual
Prefix:
First Name:CHARLIE
Middle Name:JIJER
Last Name:CHANGCHIEN
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:1 RIVERVIEW PLZ
Mailing Address - Street 2:MILLENNIUM PEDIATRIC CARE, RIVERVIEW MEDICAL CENTER
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-1864
Mailing Address - Country:US
Mailing Address - Phone:732-450-2801
Mailing Address - Fax:732-450-2802
Practice Address - Street 1:1 RIVERVIEW PLZ
Practice Address - Street 2:MILLENNIUM PEDIATRIC CARE, RIVERVIEW MEDICAL CENTER
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1864
Practice Address - Country:US
Practice Address - Phone:732-450-2801
Practice Address - Fax:732-450-2802
Is Sole Proprietor?:No
Enumeration Date:2007-12-18
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA08348300208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics