MEDICARE: DR. HELEN SHIM- CHANG MD

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	207ND0900X	Dermatopathology Physician	192475	NY
2	207ZP0101X	Anatomic Pathology Physician	192475	NY
3	207N00000X	Dermatology Physician	192475	NY

General Provider Information

NPI Number	:	1730187543
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HELEN SHIM- CHANG MD

Provider Business Mailing Address
First Line	:	5 E 98TH ST FL 5
Second Line	:	MOUNT SINAI MEDICAL CENTER, DEPT OF DERMATOLOGY
City	:	NEW YORK
State	:	NY
Zip	:	10029-6501
Country	:	US
Telephone Number	:	212-241-9728
Fax Number	:	212-987-1197

Provider Business Practice Location Address
First Line	:	5 E 98TH ST FL 5
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10029-6501
Country	:	US
Telephone Number	:	212-241-3050
Fax Number	:	212-987-1197

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

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	05/13/2009

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