Provider Demographics
NPI:1083176408
Name:CHAN, RACHEL ALISON LIM (DO)
Entity type:Individual
Prefix:
First Name:RACHEL ALISON
Middle Name:LIM
Last Name:CHAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:LIM
Other - Last Name:CHAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:2301 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-5418
Mailing Address - Country:US
Mailing Address - Phone:908-917-9820
Mailing Address - Fax:
Practice Address - Street 1:254 EASTON AVE
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-1766
Practice Address - Country:US
Practice Address - Phone:877-746-7090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-04
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A20896207L00000X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology