Provider Demographics
NPI:1124071261
Name:CHUBACK, JOHN ASGHAR (JOHN CHUBACK, MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:ASGHAR
Last Name:CHUBACK
Suffix:
Gender:M
Credentials:JOHN CHUBACK, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 ROBIN RD STE 333
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-1424
Mailing Address - Country:US
Mailing Address - Phone:201-261-1772
Mailing Address - Fax:201-261-1776
Practice Address - Street 1:205 ROBIN RD STE 333
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-1424
Practice Address - Country:US
Practice Address - Phone:201-261-1772
Practice Address - Fax:201-261-1776
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA65556208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8915601Medicaid
NJ8915601Medicaid
NJ057534Medicare PIN