1144366568 NPI number — BORO AUDIOLOGY, INC.

Table of content: DR. CHEE CHIANG CHANG DDS (NPI 1730154394)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144366568 NPI number — BORO AUDIOLOGY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BORO AUDIOLOGY, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144366568
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/30/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
207 PROSPECT PARK SW
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:
11218-1500
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-622-3500
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
207 PROSPECT PARK SW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11218
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-622-3500
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/30/2007

Additional Information

Authorized Official

Authorized Official Last Name:
OYIBORHORO
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
MA
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
718-622-3500

Provider Taxonomy Codes

  • Taxonomy code: 332S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 231H00000X , with the licence number: 00959 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 165380 . This is a "ELDERPLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 4500089 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: KS723 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 418986P . This is a "HIP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 01316449 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2026 www.npivalidator.com