MEDICARE: ERIC CHANG DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VX0000X	Obstetrics Physician	25MB08395900	NJ
2	207VG0400X	Gynecology Physician	25MB08395900	NJ
3	207VG0400X	Gynecology Physician	301263	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538321203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC CHANG DO

Provider Business Mailing Address
First Line	:	835 HOPKINS RD
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14221-2322
Country	:	US
Telephone Number	:	716-688-5131
Fax Number	:	716-636-1940

Provider Business Practice Location Address
First Line	:	835 HOPKINS RD
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14221-2322
Country	:	US
Telephone Number	:	315-469-8700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2008
Last Update Date	:	04/26/2021

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Directions to “ ERIC CHANG DO” Practice Location

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