Provider Demographics
NPI:1669089355
Name:TRANS PACIFIC MEDICAL PC
Entity type:Organization
Organization Name:TRANS PACIFIC MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:CHIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:KUWAMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-581-8553
Mailing Address - Street 1:1590 ANDERSON AVE PH 1
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-2711
Mailing Address - Country:US
Mailing Address - Phone:201-581-8553
Mailing Address - Fax:201-270-0257
Practice Address - Street 1:1590 ANDERSON AVE PH 1
Practice Address - Street 2:
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-2711
Practice Address - Country:US
Practice Address - Phone:201-581-8553
Practice Address - Fax:201-270-0257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-26
Last Update Date:2020-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MA07665000OtherMEDICAL LICENSE
1275673907OtherNPI