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General NPI Number Information
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NPI Number | 1699925420
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Entity Type | Individual
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Provider Name | ELLEN J CHANG O.D.
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Gender | Female
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Dates
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Enumeration Date | 09/29/2008
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Last Update Date | 05/07/2010
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Provider Practice Location Address
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Address Line | 5570 XAVIER DR
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City | YONKERS
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State | NY
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Zip | 10704-1322
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Country | US
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Telephone | 914-962-6600
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Fax |
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Provider Business Mailing Address
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Address Line | 5570 XAVIER DR
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City | YONKERS
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State | NY
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Zip | 10704-1322
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Country | US
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Telephone | 310-923-1712
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | T13619
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 152WL0500X
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Taxonomy Name | Low Vision Rehabilitation Optometrist
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License Number | T13619
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TUV007437-1
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License Number State | NY
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