Healthcare Provider Details

I. General information

NPI: 1790129526
Provider Name (Legal Business Name): JUDY HSIN-T'ING CH'ANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JUDY HSIN-TING CH'ANG MD

II. Dates (important events)

Enumeration Date: 04/23/2013
Last Update Date: 08/14/2024
Certification Date: 08/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 E 68TH ST
NEW YORK NY
10065-4870
US

IV. Provider business mailing address

525 E 68TH ST STE F-610
NEW YORK NY
10065-4870
US

V. Phone/Fax

Practice location:
  • Phone: 212-746-5454
  • Fax:
Mailing address:
  • Phone: 212-746-0382
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A2900X
TaxonomyNeurocritical Care Physician
License Number298372
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2084A2900X
TaxonomyNeurocritical Care Physician
License Number036-163995
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: