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General NPI Number Information
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NPI Number | 1255837639
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Entity Type | Individual
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Provider Name | JULIANA CHANG
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Gender | Female
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Dates
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Enumeration Date | 04/04/2018
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Last Update Date | 07/29/2021
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Provider Practice Location Address
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Address Line | 27005 76TH AVE
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-1402
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Country | US
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Telephone | 516-470-7873
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Fax |
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Provider Business Mailing Address
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Address Line | 18 BEVERLY RD
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City | PORT WASHINGTON
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State | NY
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Zip | 11050-3018
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Country | US
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Telephone | 570-878-9961
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 309244
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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