Individual
DR. BONG CHANG
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1140 ROUTE 72 W, MANAHAWKIN, NJ 08050-2412
(609) 978-2194
Mailing address
1020A E BOAL AVE, BOALSBURG, PA 16827-1509
(814) 237-8627
(814) 238-0083
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
MA04440400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0128805
—
NJ
01
—
0231571000
AMERIHEALTH HMO/POS
NJ
01
—
1K5038
HEALTHNET
NJ
01
—
2351609
AETNA HMO
NJ
01
—
28536
UNIVERSITY HEALTH PLAN
NJ
01
—
400377
AMERIHEALTH PPO
NJ
01
—
4319635
AETNA PPO
NJ
01
—
P2063667
OXFORD
NJ
Enumeration date
12/20/2005
Last updated
07/08/2007
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