MEDICARE: NGA 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	208D00000X	General Practice Physician	148111	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538222039
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NGA CHANG MD

Provider Business Mailing Address
First Line	:	6236 MAIN STREET
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11367-1125
Country	:	US
Telephone Number	:	718-359-0489
Fax Number	:

Provider Business Practice Location Address
First Line	:	81 ELIZABETH ST
Second Line	:	SUITE 401
City	:	NEW YORK
State	:	NY
Zip	:	10013-4729
Country	:	US
Telephone Number	:	212-431-7098
Fax Number	:	212-431-7098

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

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	08/08/2013

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Directions to “ NGA CHANG MD” Practice Location

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