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NPI Code Detail

MEDICARE: MS. ANGELA CARLETA CHANG PHD, LCSW-R

MEDICARE: MS. ANGELA CARLETA CHANG PHD, LCSW-R
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
11041C0700XClinical Social WorkerR044643NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1044643OTHERNYLICENSE

General Provider Information

NPI Number : 1336437318
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ANGELA CARLETA CHANG PHD, LCSW-R
Provider Business Mailing Address
First Line : 15046 SHORE AVE
Second Line :
City : JAMAICA
State : NY
Zip : 11433-1930
Country : US
Telephone Number : 631-521-4348
Fax Number : 631-253-4525
Provider Business Practice Location Address
First Line : 1763 ROCKAWAY PKWY
Second Line :
City : BROOKLYN
State : NY
Zip : 11236-5037
Country : US
Telephone Number : 718-734-7806
Fax Number : 631-920-5111
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2011
Last Update Date : 01/21/2021

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