Healthcare Provider Details

I. General information

NPI: 1538460159
Provider Name (Legal Business Name): CONSTANCE T. CHANG NP.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/12/2010
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2185 GALLOWAY RD
BENSALEM PA
19020-2983
US

IV. Provider business mailing address

PO BOX 1068
BENSALEM PA
19020-5068
US

V. Phone/Fax

Practice location:
  • Phone: 610-871-7200
  • Fax:
Mailing address:
  • Phone: 610-871-7200
  • Fax: 610-871-6210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number336554
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN00588
License Number StateRI
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNPP37634
License Number StateRI
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2292523
License Number StateMA
# 5
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPRN00588
License Number StateRI
# 6
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP024146
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: