Basic Information
| Provider Information | |||||||||
| NPI: | 1760446322 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHAE | ||||||||
| FirstName: | HUNG | ||||||||
| MiddleName: | Y | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | P.O. BOX 949 | ||||||||
| Address2: | |||||||||
| City: | FORT LEE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07024 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7326079090 | ||||||||
| FaxNumber: | 7326071160 | ||||||||
| Practice Location | |||||||||
| Address1: | 400 SYLVAN AVE, STE 103 | ||||||||
| Address2: | |||||||||
| City: | ENGLEWOOD CLIFFS | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07632 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7324423700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/12/2006 | ||||||||
| LastUpdateDate: | 01/26/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 25MA04523900 | NJ | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 5S20002 | 05 | NJ | MEDICAID |