Individual
DR. JISUN CHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
65 BROADWAY STE 1606, NEW YORK, NY 10006-2562
(267) 737-8655
Mailing address
10 LIBERTY ST APT 21C, NEW YORK, NY 10005-1549
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
25MA09071200
NJ
207N00000X
Dermatology Physician
266475
NY
207N00000X
Dermatology Physician
MD12915
RI
207N00000X
Dermatology Physician
MD465852
PA
207ND0900X
Dermatopathology Physician
25MA09071200
NJ
207ND0900X
Dermatopathology Physician
Primary
266475
NY
207ND0900X
Dermatopathology Physician
MA09071200
RI
207ND0900X
Dermatopathology Physician
MD465852
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0315176
—
NJ
Enumeration date
05/27/2009
Last updated
09/23/2021
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