Provider Demographics
NPI:1396888202
Name:DEPARTMENT OF VETERANS AFFAIRS, NJ HEALTH CARE SYSTEM
Entity type:Organization
Organization Name:DEPARTMENT OF VETERANS AFFAIRS, NJ HEALTH CARE SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:
Authorized Official - First Name:SHANG-YI
Authorized Official - Middle Name:SONYA
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-542-0664
Mailing Address - Street 1:5 POTOMAC DR
Mailing Address - Street 2:
Mailing Address - City:BASKING RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07920-3188
Mailing Address - Country:US
Mailing Address - Phone:908-542-0664
Mailing Address - Fax:
Practice Address - Street 1:5 POTOMAC DR
Practice Address - Street 2:
Practice Address - City:BASKING RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07920-3188
Practice Address - Country:US
Practice Address - Phone:908-542-0664
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR09435900286500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital