Healthcare Provider Details

I. General information

NPI: 1609010693
Provider Name (Legal Business Name): HSIN CHENG CHAO, MDPC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2009
Last Update Date: 04/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 COUNTRY CLUB LN
SCARBOROUGH NY
10510-2433
US

IV. Provider business mailing address

17 COUNTRY CLUB LN
SCARBOROUGH NY
10510-2433
US

V. Phone/Fax

Practice location:
  • Phone: 914-302-2840
  • Fax: 914-302-2838
Mailing address:
  • Phone: 914-302-2840
  • Fax: 914-302-2838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number108583-1
License Number StateNY

VIII. Authorized Official

Name: HSIN CHENG CHAO
Title or Position: PRESIDENT
Credential: MD
Phone: 914-302-2840