Healthcare Provider Details

I. General information

NPI: 1255404976
Provider Name (Legal Business Name): MING C CHIOU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 03/06/2024
Certification Date: 03/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 MAPLE AVE
WARWICK NY
10990-1028
US

IV. Provider business mailing address

15 MAPLE AVE PO BOX 875
WARWICK NY
10990-1028
US

V. Phone/Fax

Practice location:
  • Phone: 845-294-2006
  • Fax: 845-615-1590
Mailing address:
  • Phone: 845-294-2006
  • Fax: 845-615-1590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number110378-01
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number110378-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: