Mysty Chacko, PA-C
Physician Assistant in Moorestown, New Jersey
1669003745- Practice location
- 400 W Route 38, Moorestown, NJ 08057-3219
- Phone
- 856-270-4000
- Fax
- —
- Last updated
- August 7, 2024
Mysty Chacko is a Physician Assistant based in Moorestown, NJ. Mysty Chacko practices in Moorestown, NJ and has the professional credentials of PA-C. The NPI Number for Mysty Chacko is 1669003745 and holds a License No. MA061392 (PA). The current practice location address for Mysty Chacko is 400 W Route 38, Moorestown, NJ 08057-3219 and can be reached out via phone at 856-270-4000.
Provider Profile Details
- NPI Number
- 1669003745
- Provider Name
- Mysty Chacko
- Credential
- PA-C
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 400 W Route 38, Moorestown, NJ 08057-3219
- Phone Number
- 856-270-4000
- Primary Taxonomy
- Physician Assistant · 363A00000X
- Sole Proprietor
- No
- Provider Enumeration Date
- January 28, 2020
- Last Update Date
- August 7, 2024
- Certification Date
- August 7, 2024
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 400 W Route 38
Moorestown, NJ 08057-3219 - City
- Moorestown
- State
- New Jersey
- Zip
- 08057-3219
- Phone Number
- 856-270-4000
Provider Business Mailing Address Details
- Address
- 1 Federal St Ste 200
Camden, NJ 08103-1088 - City
- Camden
- State
- NJ
- Zip
- 08103-1088
- Phone Number
- 848-288-6935
- Fax Number
- 732-790-0107
License Information
- License Number (1)
- MA061392
- License State (1)
- PA
- Taxonomy (1)
- Internal Medicine, Gastroenterology · 207RG0100X
- License Number (2)
- 25MP00866300
- License State (2)
- NJ
- Taxonomy (2)
- Physician Assistant · 363A00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Mysty Chacko, PA-C?
The NPI number of Mysty Chacko, PA-C is 1669003745. It was assigned on January 28, 2020 and is currently active in the NPPES registry.
What is the specialty of Mysty Chacko, PA-C?
Mysty Chacko, PA-C is registered under the primary taxonomy Physician Assistant (code 363A00000X), licensed in PA under license number MA061392.
Where does Mysty Chacko, PA-C practice?
The practice location is 400 W Route 38, Moorestown, NJ 08057-3219. The office can be reached at 856-270-4000 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1669003745 directly on the NPPES registry website.