1851409650 NPI number — DR. SCOTT S CHAE M.D.

Table of content: DR. SCOTT S CHAE M.D. (NPI 1851409650)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851409650 NPI number — DR. SCOTT S CHAE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHAE
Provider First Name:
SCOTT
Provider Middle Name:
S
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1851409650
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/12/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2 STATE ROUTE 27
Provider Second Line Business Mailing Address:
SUITE 107
Provider Business Mailing Address City Name:
EDISON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08820-3976
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-632-9777
Provider Business Mailing Address Fax Number:
732-632-8096

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2 STATE ROUTE 27
Provider Second Line Business Practice Location Address:
SUITE 107
Provider Business Practice Location Address City Name:
EDISON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08820-3961
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-632-9777
Provider Business Practice Location Address Fax Number:
732-632-8096
Provider Enumeration Date:
08/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RG0100X , with the licence number:  MA056559 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1004599800 . This is a "AMERICHOICE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 5457461 . This is a "AETNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 2110342000 . This is a "AMERIHEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 2K2314 . This is a "HEALTHNET" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 4564103 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: P765009 . This is a "OXFORD" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1168007 . This is a "HORIZON" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 15011 . This is a "AMERIGROUP" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 100016710 . This is a "RAILROAD MCR" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 9518278 . This is a "CIGNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 8211972 . This is a "GHI" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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