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General NPI Number Information
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NPI Number | 1154307262
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Entity Type | Organization
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Legal Business Name | JOHN B. CHANG,MDPC
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Dates
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Enumeration Date | 12/20/2005
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Last Update Date | 03/08/2010
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Provider Practice Location Address
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Address Line | 1050 NORTHERN BLVD
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City | ROSLYN
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State | NY
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Zip | 11576-1503
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Country | US
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Telephone | 516-484-3430
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Fax | 516-484-3482
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Provider Business Mailing Address
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Address Line | 1050 NORTHERN BLVD
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City | ROSLYN
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State | NY
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Zip | 11576-1503
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Country | US
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Telephone | 516-484-3430
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Fax | 516-484-3482
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Authorized Official
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Title or Position | VICE-PRESIDENT
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Name | DR. LUCY CHANG
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Credential | MD
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Telephone | 516-484-3430
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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