Provider Demographics
NPI:1528499571
Name:PIONEER HEALTH AND MEDICAL INC
Entity type:Organization
Organization Name:PIONEER HEALTH AND MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIONE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-888-8331
Mailing Address - Street 1:875 POOLE AVE
Mailing Address - Street 2:
Mailing Address - City:HAZLET
Mailing Address - State:NJ
Mailing Address - Zip Code:07730-2041
Mailing Address - Country:US
Mailing Address - Phone:732-888-8331
Mailing Address - Fax:
Practice Address - Street 1:875 POOLE AVE
Practice Address - Street 2:
Practice Address - City:HAZLET
Practice Address - State:NJ
Practice Address - Zip Code:07730-2041
Practice Address - Country:US
Practice Address - Phone:732-888-8331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-02
Last Update Date:2013-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09386600207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty