Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 220385 | MA |
NPI | 1023022522 |
---|---|
Provider Name | Amy S Chang |
First Address | North Easton, MA 02356-1032 |
Second Address | North Easton, MA 02356-1032 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2006 |
Last Update Date | 12/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
109499 | (02) | |
2064821 | (05) | MA |