Provider Demographics
NPI:1588694657
Name:CHAO, CHRISTINA (MD)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:CHAO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1617 ROUTE 38
Mailing Address - Street 2:STE. 4
Mailing Address - City:LUMBERTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08048-2919
Mailing Address - Country:US
Mailing Address - Phone:609-261-0240
Mailing Address - Fax:609-261-8622
Practice Address - Street 1:23659 COLUMBUS ROAD
Practice Address - Street 2:STE. 4
Practice Address - City:COLUMBUS
Practice Address - State:NJ
Practice Address - Zip Code:08022-1980
Practice Address - Country:US
Practice Address - Phone:609-261-0240
Practice Address - Fax:609-261-5181
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04542000207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ391701Medicaid
NJ391701Medicaid
NJ143704Medicare PIN