Provider Demographics
NPI:1174773790
Name:CHING, JOHN DZAAN
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:DZAAN
Last Name:CHING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1146 72ND ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-1306
Mailing Address - Country:US
Mailing Address - Phone:718-853-2845
Mailing Address - Fax:718-853-2846
Practice Address - Street 1:4721 8TH AVE
Practice Address - Street 2:SUITEA
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-1519
Practice Address - Country:US
Practice Address - Phone:718-853-2845
Practice Address - Fax:718-853-2846
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-19
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045832183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist