Active NPI
Pil Jae Chang, PHARM D.
- Pharmacist
- Deptford, NJ
National Provider Identifier
1376809319
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28RI03093700
- Practice address
- 2000 Clements Bridge Rd
Deptford, NJ 08096-2016 - Phone
- (856) 384-6740
- NPI assigned
- Apr 4, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28RI03093700 | NJ | Primary |
Addresses
Primary practice location
2000 Clements Bridge Rd
Deptford, NJ 08096-2016
Mailing address
2000 Clements Bridge Rd
Deptford, NJ 08096-2016
Phone (856) 384-6740
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0193887 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28RI03093700 | NJ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1333497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1515715200000",
"number": "1376809319",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2000 CLEMENTS BRIDGE RD",
"city": "DEPTFORD",
"state": "NJ",
"postal_code": "080962016",
"telephone_number": "856-384-6740"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 CLEMENTS BRIDGE RD",
"city": "DEPTFORD",
"state": "NJ",
"postal_code": "080962016",
"telephone_number": "856-384-6740"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHANG",
"first_name": "PIL JAE",
"name_prefix": "Dr.",
"credential": "PHARM D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-04-04",
"last_updated": "2018-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI03093700",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0193887",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Deptford, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.