1467534610 NPI number — DR. KUAI-HUA CHIANG D.P.T

Table of content: DR. KUAI-HUA CHIANG D.P.T (NPI 1467534610)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467534610 NPI number — DR. KUAI-HUA CHIANG D.P.T

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHIANG
Provider First Name:
KUAI-HUA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.P.T
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1467534610
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/20/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
210-08 NORTHERN BLVD
Provider Second Line Business Mailing Address:
STE 1
Provider Business Mailing Address City Name:
BAYSIDE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11361-3050
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
347-408-4911
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
21008 NORTHERN BLVD
Provider Second Line Business Practice Location Address:
STE #1
Provider Business Practice Location Address City Name:
BAYSIDE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11361-3211
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
347-408-4911
Provider Business Practice Location Address Fax Number:
347-836-8098
Provider Enumeration Date:
10/19/2006

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: 225100000X , with the licence number:  022858 , 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: 201017900033 . This is a "AFFINITY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: CA1006250206 . This is a "AFFINITY HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 03320192 . This is a "MEDICAID" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 7794772 . This is a "AETNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 133668362 . This is a "EVECARE/UHC" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: SEIU136172 . This is a "1199 SEIU" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 03320192 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9461166 . This is a "PHCS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 836132 . This is a "THE EMPIRE PLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: Q96N32 . This is a "EMPIRE BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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