=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063586006
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JIH-LIH CHIANG MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/20/2006
-----------------------------------------------------
Last Update Date | 01/05/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 13620 38TH AVE STE 8E
-----------------------------------------------------
City | FLUSHING
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11354-4233
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-445-2581
-----------------------------------------------------
Fax | 718-445-2581
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 89 ARLEIGH RD
-----------------------------------------------------
City | GREAT NECK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11021
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-482-5305
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207K00000X
-----------------------------------------------------
Taxonomy Name | Allergy & Immunology Physician
-----------------------------------------------------
License Number | NY158250
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------