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General NPI Number Information
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NPI Number | 1063717403
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Entity Type | Individual
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Provider Name | SADIE C CHANG REGISTER NURSE
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Gender | Female
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Dates
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Enumeration Date | 01/16/2011
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Last Update Date | 01/16/2011
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Provider Practice Location Address
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Address Line | 22 OLD NORTH STAMFORD RD
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City | STAMFORD
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State | CT
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Zip | 06905-3961
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Country | US
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Telephone | 646-662-7601
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Fax |
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Provider Business Mailing Address
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Address Line | 22 OLD NORTH STAMFORD RD
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City | STAMFORD
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State | CT
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Zip | 06905-3961
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Country | US
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Telephone | 646-662-7601
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 302363-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R36052
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License Number State | CT
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