1134381908 NPI number — DR. YUMEI MARY CHANG M.D.

Table of content: DR. YUMEI MARY CHANG M.D. (NPI 1134381908)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134381908 NPI number — DR. YUMEI MARY CHANG M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHANG
Provider First Name:
YUMEI
Provider Middle Name:
MARY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CHANG
Provider Other First Name:
MARY
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1134381908
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/01/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
360 FURMAN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROOKLYN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11201-4574
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-463-5771
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
240 GREENWICH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10007-2163
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-463-5771
Provider Business Practice Location Address Fax Number:
212-815-4910
Provider Enumeration Date:
07/01/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  MD463062 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)