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General NPI Number Information
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NPI Number | 1962690446
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Entity Type | Organization
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Legal Business Name | C & W MEDICAL, LLC
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Dates
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Enumeration Date | 10/09/2007
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Last Update Date | 10/17/2007
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Provider Practice Location Address
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Address Line | 8708 JUSTICE AVE SUITE LA
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City | ELMHURST
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State | NY
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Zip | 11373-4575
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Country | US
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Telephone | 718-651-5713
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Fax | 718-651-5714
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Provider Business Mailing Address
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Address Line | 8708 JUSTICE AVE SUITE LA
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City | ELMHURST
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State | NY
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Zip | 11373-4575
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Country | US
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Telephone | 718-651-5713
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Fax | 718-651-5714
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | DR. CHUANXIANG CHI
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Credential | MD
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Telephone | 718-651-5713
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 227282
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License Number State | NY
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