Organization · NPI-2

Alice Chang, MD LLC

Clinic/Center, Adult Mental Health · Marlton, NJ

NPI number1083309793
StatusActive
Last updated in NPPESApr 13, 2023

Details

NPI
1083309793
Entity type
Organization (NPI-2)
Legal business name
Alice Chang, MD LLC
Organization subpart
No
Enumeration date
Apr 7, 2023
Certification date
Apr 7, 2023
Last updated
Apr 13, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM0850X Clinic/Center, Adult Mental Health––Yes

Practice location

525 Route 73 N
Suite 104
Marlton, NJ 08053

Phone 609-200-0211

Mailing address

970 Haddon Ave Unit 8774
Collingswood, NJ 08108-8038

Phone 609-200-0211

Authorized official

Alice Chang
Owner
6092000211

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