Provider Demographics
NPI:1699157446
Name:ORELLANA CHASI, PAMELA (MD)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:ORELLANA CHASI
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 1:801 74TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-4829
Mailing Address - Country:US
Mailing Address - Phone:201-869-5778
Mailing Address - Fax:
Practice Address - Street 1:4800 PARK AVE
Practice Address - Street 2:
Practice Address - City:WEEHAWKEN
Practice Address - State:NJ
Practice Address - Zip Code:07086
Practice Address - Country:US
Practice Address - Phone:201-330-8747
Practice Address - Fax:201-330-8947
Is Sole Proprietor?:No
Enumeration Date:2015-06-28
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA10373600207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine