Provider Demographics
NPI:1801901202
Name:HUANG, CHEN YA (MD)
Entity type:Individual
Prefix:DR
First Name:CHEN YA
Middle Name:
Last Name:HUANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JACOB
Other - Middle Name:CHEN YA
Other - Last Name:HUANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:270 ROUTE 206, BARTLEY SQUARE
Mailing Address - Street 2:
Mailing Address - City:FLANDERS
Mailing Address - State:NJ
Mailing Address - Zip Code:07836
Mailing Address - Country:US
Mailing Address - Phone:973-584-0233
Mailing Address - Fax:973-584-0037
Practice Address - Street 1:270 HIGHWAY 206
Practice Address - Street 2:
Practice Address - City:FLANDERS
Practice Address - State:NJ
Practice Address - Zip Code:07836-9082
Practice Address - Country:US
Practice Address - Phone:973-584-0233
Practice Address - Fax:973-584-0037
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02822400207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0108779001OtherAMERIHEALTH
NJCO7934Medicare UPIN
NJ500012Medicare PIN