MEDICARE: DR. CHI CHING SHUM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	206710	NY

General Provider Information

NPI Number	:	1033143003
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHI CHING SHUM MD

Provider Business Mailing Address
First Line	:	100 UNITED NATIONS PLZ APT 42A
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10017-1756
Country	:	US
Telephone Number	:	917-664-7418
Fax Number	:	646-585-9194

Provider Business Practice Location Address
First Line	:	210 E 47TH ST APT 1A
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10017-2104
Country	:	US
Telephone Number	:	212-308-4894
Fax Number	:	646-585-9194

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	01/08/2024

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