MEDICARE: DR. JOHN CHU-HONG CHANG M.D.

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	207W00000X	Ophthalmology Physician	225687	NY
2	174400000X	Specialist	225687-1	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00014839	OTHER	NY	PALMETTO GBA RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	132998987	OTHER	NY	TAX ID
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073516027
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN CHU-HONG CHANG M.D.

Provider Business Mailing Address
First Line	:	169 N MIDDLETOWN RD
Second Line	:
City	:	PEARL RIVER
State	:	NY
Zip	:	10965-2029
Country	:	US
Telephone Number	:	845-735-5666
Fax Number	:	845-735-5673

Provider Business Practice Location Address
First Line	:	169 N MIDDLETOWN RD
Second Line	:
City	:	PEARL RIVER
State	:	NY
Zip	:	10965-2029
Country	:	US
Telephone Number	:	845-735-5666
Fax Number	:	845-735-5673

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	04/05/2017

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Directions to “ DR. JOHN CHU-HONG CHANG M.D.” Practice Location

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