Chan, Joseph A

Chan, Joseph A is an sole proprietor health care provider with primary practice located at 85 Park St , Montclair NJ 07042-2905. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Chan, Joseph A can be contacted via phone (973) 202-1421.

Contact Information

Primary practice address
85 Park St Montclair NJ 07042-2905
Fax: (973) 707-7616
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 44SC05184400 New Jersey

Profile Details

NPI number 1962548560
LBN Legal business name Chan, Joseph A
Credentials MSW, LCSW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 30th, 2007
Last updated Aug 13th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962548560 NPPES
New Jersey Other 205791081 TAX IDENTIFICATION NUMBER

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