Provider Demographics
NPI:1023755105
Name:CHINJEN, PATRICK JOSEPH (PTA)
Entity type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:JOSEPH
Last Name:CHINJEN
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 MARKOWITZ ST
Mailing Address - Street 2:
Mailing Address - City:CARTERET
Mailing Address - State:NJ
Mailing Address - Zip Code:07008-1632
Mailing Address - Country:US
Mailing Address - Phone:908-510-4344
Mailing Address - Fax:
Practice Address - Street 1:77 BRANT AVE STE 101
Practice Address - Street 2:
Practice Address - City:CLARK
Practice Address - State:NJ
Practice Address - Zip Code:07066-1540
Practice Address - Country:US
Practice Address - Phone:732-499-4540
Practice Address - Fax:732-499-4577
Is Sole Proprietor?:No
Enumeration Date:2022-05-19
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QB00308100225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant