Active NPI
Chaya Back
- Registered Nurse
- Elizabeth, NJ
National Provider Identifier
1760782015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 636800
- Practice address
- 750 N Broad St Apt 1J
Elizabeth, NJ 07208-2423 - Phone
- (732) 267-3988
- NPI assigned
- Nov 2, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 636800 | NY | Primary |
Addresses
Primary practice location
750 N Broad St Apt 1J
Elizabeth, NJ 07208-2423
Mailing address
750 N Broad St Apt 1J
Elizabeth, NJ 07208-2423
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 636800 | NY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288656000000",
"number": "1760782015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "750 N BROAD ST APT 1J",
"city": "ELIZABETH",
"state": "NJ",
"postal_code": "072082423"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "750 N BROAD ST APT 1J",
"city": "ELIZABETH",
"state": "NJ",
"postal_code": "072082423",
"telephone_number": "732-267-3988"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BACK",
"first_name": "CHAYA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-11-02",
"last_updated": "2010-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "636800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elizabeth, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.