Provider Demographics
NPI:1801955901
Name:ARTHUR W CHANEY JR & DEWEY A CHANEY PTR
Entity type:Organization
Organization Name:ARTHUR W CHANEY JR & DEWEY A CHANEY PTR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:W
Authorized Official - Last Name:CHANEY
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:201-343-5035
Mailing Address - Street 1:259 BERRY ST
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-2707
Mailing Address - Country:US
Mailing Address - Phone:201-343-5035
Mailing Address - Fax:201-996-1061
Practice Address - Street 1:259 BERRY ST
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-2707
Practice Address - Country:US
Practice Address - Phone:201-343-5035
Practice Address - Fax:201-996-1061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02142700207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2847604Medicaid
NJC60934Medicare UPIN
NJ526674Medicare PIN
NJ2847604Medicaid