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General NPI Number Information
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NPI Number | 1275873085
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Entity Type | Organization
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Legal Business Name | CHARLENE CHAO, MD, PLLC
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Dates
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Enumeration Date | 02/15/2013
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Last Update Date | 12/23/2024
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Provider Practice Location Address
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Address Line | 802 64TH STREET STE 2F
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City | BROOKLYN
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State | NY
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Zip | 11220-5573
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Country | US
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Telephone | 718-833-2699
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Fax | 718-833-2667
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Provider Business Mailing Address
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Address Line | 802 64TH STREET STE 2F
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City | BROOKLYN
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State | NY
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Zip | 11220-5573
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Country | US
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Telephone | 718-833-2699
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Fax | 718-833-2667
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Authorized Official
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Title or Position | OWNER
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Name | CHARLENE CHAO
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Credential | MD
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Telephone | 718-833-2699
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 243672
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License Number State | MA
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