MEDICARE: JEAN SHANN-CHING YING-CHANG 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	2084P0804X	Child & Adolescent Psychiatry Physician	MA64364	NJ

General Provider Information

NPI Number	:	1386670800
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEAN SHANN-CHING YING-CHANG MD

Provider Business Mailing Address
First Line	:	50 MORRIS AVE
Second Line	:
City	:	DENVILLE
State	:	NJ
Zip	:	07834-1735
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	50 MORRIS AVE
Second Line	:
City	:	DENVILLE
State	:	NJ
Zip	:	07834-1735
Country	:	US
Telephone Number	:	973-625-7009
Fax Number	:	972-625-7128

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

Provider Enumeration Date	:	06/25/2006
Last Update Date	:	07/08/2007

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