Provider Demographics
NPI:1053537399
Name:CHANG, JAMES H (LAC)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:H
Last Name:CHANG
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 EISTEIN WAY
Mailing Address - Street 2:
Mailing Address - City:CRANBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:08512
Mailing Address - Country:US
Mailing Address - Phone:732-424-8203
Mailing Address - Fax:609-426-8655
Practice Address - Street 1:160 TICES LN FL 1
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-2016
Practice Address - Country:US
Practice Address - Phone:732-424-8203
Practice Address - Fax:609-426-8655
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00050700171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MZ00050700OtherACUPUNCTURIST