Individual
ANDRES CHACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
70 RIDGE RD, LYNDHURST, NJ 07071-1216
(201) 933-9959
(201) 933-9958
Mailing address
576 BROADHOLLOW RD, MELVILLE, NY 11747-5002
(631) 359-5859
(631) 396-0864
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA01903000
NJ
Other
Enumeration date
02/10/2020
Last updated
02/10/2020
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