Provider Demographics
NPI:1952383275
Name:CHI, JINHAN (MD)
Entity Type:Individual
Prefix:
First Name:JINHAN
Middle Name:
Last Name:CHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1259 ROUTE 46
Mailing Address - Street 2:TROY OFFICE CENTER, BUILDING #3
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-4913
Mailing Address - Country:US
Mailing Address - Phone:973-402-0070
Mailing Address - Fax:973-402-0093
Practice Address - Street 1:255 BALDWIN RD STE 105
Practice Address - Street 2:
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-7501
Practice Address - Country:US
Practice Address - Phone:973-402-0070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-14
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07626000207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I00850Medicare UPIN