Provider Demographics
NPI:1093087207
Name:CHONG, CHRISTINA EUNHAE (MS, RD, LDN)
Entity type:Individual
Prefix:MISS
First Name:CHRISTINA
Middle Name:EUNHAE
Last Name:CHONG
Suffix:
Gender:
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 LIPPINCOTT DR STE 410
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4197
Mailing Address - Country:US
Mailing Address - Phone:856-325-4270
Mailing Address - Fax:
Practice Address - Street 1:2309 E EVESHAM RD STE 101C
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-1559
Practice Address - Country:US
Practice Address - Phone:856-325-4270
Practice Address - Fax:856-325-4271
Is Sole Proprietor?:No
Enumeration Date:2012-02-02
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN004720133V00000X
NJ998558133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered