Healthcare Provider Details

I. General information

NPI: 1730187543
Provider Name (Legal Business Name): HELEN SHIM- CHANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2005
Last Update Date: 05/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 E 98TH ST FL 5
NEW YORK NY
10029-6501
US

IV. Provider business mailing address

5 E 98TH ST FL 5 MOUNT SINAI MEDICAL CENTER, DEPT OF DERMATOLOGY
NEW YORK NY
10029-6501
US

V. Phone/Fax

Practice location:
  • Phone: 212-241-3050
  • Fax: 212-987-1197
Mailing address:
  • Phone: 212-241-9728
  • Fax: 212-987-1197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License Number192475
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number192475
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number192475
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: