Healthcare Provider Details

I. General information

NPI: 1245306554
Provider Name (Legal Business Name): NANCY CHIANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

86 CARMAN AVE
CEDARHURST NY
11516-1905
US

IV. Provider business mailing address

42 STANWOOD RD
NEW HYDE PARK NY
11040-3608
US

V. Phone/Fax

Practice location:
  • Phone: 516-569-0500
  • Fax:
Mailing address:
  • Phone: 516-294-2912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number214854
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: