Individual
MR. BRIAN CHABALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
19 DAVIS AVE, FL 2, NEPTUNE, NJ 07753
(732) 776-4135
Mailing address
331 NEWMAN SPRINGS RD, BLDG 2, STE 220, RED BANK, NJ 07701-5688
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00917900
NJ
363AS0400X
Surgical Physician Assistant
25MP00917900
NJ
Other
Enumeration date
03/17/2025
Last updated
04/14/2025
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