Chang Bae Son is a Dermatology in Englewood, New Jersey. Chang Bae Son practices all healthcare services and medical treatments related to Dermatology. The NPI Number for Chang Bae Son is 1063493898. The last update date is 2023-02-12.
Chang Bae Son's current location address is 200 Grand Ave 201, Englewood, New Jersey. You can contact this provider via phone number 2019443800 and fax number 2019443804. The mailing address for Chang Bae Son is 200 Grand Ave 201, Englewood, New Jersey. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Chang Bae Son |
|---|---|
| Address | 200 Grand Ave 201, Englewood, New Jersey |
| Phone Number | 2019443800 |
| Fax Number | 2019443804 |
| Sole Proprietor | Y |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1063493898 |
|---|---|
| Provider Enumeration Date | 2005-11-09 |
| Last Updated Date | 2023-02-12 |
Provider Mailing Address Detail
| Address | 200 Grand Ave 201 |
|---|---|
| City | Englewood |
| State | New Jersey (NJ) |
| Post Code | 76314363 |
| Phone Number | 2019443800 |
| Fax Number | 2019443804 |
Provider's Primary Taxonomy Detail
| Speciality | Dermatology |
|---|---|
| Taxonomy | 207N00000X |
| Licence No | MD425589 |
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Definition: A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 25MA08185100 | NJ | NJ LICENSE |
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What is the Chang Bae Son's unique identification number?
The Chang Bae Son has been assigned the NPI (National Provider Identifier) Number 1063493898 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
What is the Chang Bae Son's area of specialization and corresponding taxonomy classification?
The Chang Bae Son's specialty field is Dermatology, and it falls under the taxonomy code 207N00000X, which categorizes healthcare providers based on their specialties.
On what date did the Chang Bae Son receive its 1063493898 assignment from the Centers for Medicare & Medicaid Services?
The Chang Bae Son was assigned its 1063493898 by the Centers for Medicare & Medicaid Services on 2005-11-09.
As of what date were the Chang Bae Son's details last updated?
The information pertaining to the Chang Bae Son, including its address, specialty, and other details, was most recently updated on 2023-02-12.
As of what date were the details related to Chang Bae Son most recently updated or revised?
The information pertaining to Chang Bae Son, including its address, specialty, and other relevant details, was last updated or revised on 2023-02-12.