Healthcare Provider Details

I. General information

NPI: 1932474236
Provider Name (Legal Business Name): CHIEN KUO CHIANG M D P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2012
Last Update Date: 04/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 LAFAYETTE ST SUITE 701
NEW YORK NY
10013-4154
US

IV. Provider business mailing address

109 LAFAYETTE ST SUITE 701
NEW YORK NY
10013-4154
US

V. Phone/Fax

Practice location:
  • Phone: 212-941-7856
  • Fax: 212-941-8951
Mailing address:
  • Phone: 212-941-7856
  • Fax: 212-941-8951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number177439
License Number StateNY

VIII. Authorized Official

Name: DR. CHIEN KUO CHIANG
Title or Position: DR
Credential: MD
Phone: 212-941-7856