Individual
DR. CHANG BAE SON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 GRAND AVE 201, ENGLEWOOD, NJ 07631-4363
(201) 944-3800
(201) 944-3804
Mailing address
200 GRAND AVE 201, ENGLEWOOD, NJ 07631-4363
(201) 944-3800
(201) 944-3804
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
25MA08185100
NJ
207N00000X
Dermatology Physician
MD425589
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25MA08185100
NJ LICENSE
NJ
Enumeration date
11/09/2005
Last updated
02/12/2023
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