DR. CHANG BAE SON (NPI# 1063493898) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063493898 |
| Entity Type | Individual |
| Full Name | DR. CHANG BAE SON |
| Credential | MD |
| Practice Address |
200 Grand Ave 201 Englewood NJ 07631-4363 |
| Practice Telephone | 2019443800 |
| Practice Fax Number | 2019443804 |
| Mailing Telephone | 2019443800 |
| Mailing Fax Number | 2019443804 |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2015-08-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 25MA08185100 | NJ | Allopathic & Osteopathic Physicians |
| N | 207N00000X | Dermatology | MD425589 | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | NJ LICENSE | 25MA08185100 | 01 |
| Street Address |
200 GRAND AVE 201 |
| City | ENGLEWOOD |
| State | NJ |
| Zip Code | 07631-4363 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447868922 | Sharmela Brijmohan | Student in an Organized Health Care Education/Training Program | 350 Engle Street Englewood Nj Department of Medicine, Englewood, NJ 07631 | 2020-07-21 |
| 1902422553 | Ross Tyrone Jensen Lavine | Student in an Organized Health Care Education/Training Program | 350 Engle Street, Department of Medicine, Englewood, NJ 07631 | 2020-06-19 |
| 1881235497 | Cbt and Psychodynamic Therapy Associates LLC | Social Worker | 245 Walnut Street, Englewood, NJ 07631 | 2019-10-04 |
| 1346895950 | Eb Care At Englewood, LLC | Assisted Living Facility | 412 South Van Brunt Street, Englewood, NJ 07631 | 2019-08-09 |
| 1730695727 | Maytal Elart | Spec/Tech, Cardiovascular | 151 E Palisades Ave, 16e, Englewood, NJ 07631 | 2017-12-28 |
| 1396259255 | Elizabeth Thottumalil Thomas | Counselor | 93 West Palisade Ave, Englewood, NJ 07631 | 2017-11-29 |
| 1992214381 | Englewood Orthopedics Group PC | Orthopaedic Surgery | 55 Smith St Unit 5653, Englewood, NJ 07631 | 2017-09-28 |
| 1639691579 | Jee Hoon Jang | Student in an Organized Health Care Education/Training Program | 350 Engle St., Englewood, NJ 07631 | 2017-07-12 |
| 1427570332 | Dan Ran Castillo | Student in an Organized Health Care Education/Training Program | 350 Engel Street, Engelwood, NJ 07631 | 2017-07-12 |
| 1275061392 | Thomas J Drexler | Counselor | 93 W. Palisades Ave, Englewood, NJ 07631 | 2017-06-02 |
| Find all providers in zip 07631 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326521576 | Kaitlyn Laurel Pell | Dermatology | 125 Inverness Dr E Ste 340, Englewood, CO 80112-5139 | 2018-09-13 |
| 1417357922 | Premier Dermatology, LLC | Dermatology | 900 Pine Street 122 / 123, Englewood, FL 34233-0000 | 2014-09-03 |
| 1558623496 | Annelise Lorelei Dawson | Dermatology | 499 E Hampden Ave Ste 390, Englewood, CO 80113 | 2012-06-15 |
| 1093819369 | Kimberly C Stone | Dermatology | 3701 S Clarkson St, Ste 300, Englewood, CO 80113-3960 | 2006-09-08 |
| 1134691058 | Dawson Dermatology Group Pllc | Dermatology | 499 E Hampden Ave Ste 390, Englewood, CO 80113-2780 | 2018-12-18 |
| 1811472111 | Englewood Dermatology Center | Dermatology | 300 Grand Ave Ste 201, Englewood, NJ 07631-6300 | 2018-10-02 |
| 1104274919 | Forefront Dermatology, S.c. | Dermatology | 5 W Wenger Rd, Englewood, OH 45322 | 2016-06-02 |
| 1922341783 | Jisun Cha Md | Dermatology | 460 Sylvan Ave, Englewood, NJ 07632-2919 | 2013-03-30 |
| 1497010250 | Tanya Nicole Riddle | Dermatology | 3701 S Clarkson St Ste 400, Englewood, CO 80113-3960 | 2012-07-09 |
| 1558620385 | Michelle Pennie Md LLC | Dermatology | 900 Pine St, Ste 122-123, Englewood, FL 34223-4418 | 2012-05-14 |
| Find all providers in ENGLEWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.