Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0216X | Pediatric Rheumatologist | 192592 | NY |
NPI | 1386636645 |
---|---|
Provider Name | Chun-Peng T Chao |
First Address | Hawthorne, NY 10532-1533 |
Second Address | Hawthorne, NY 10532-2140 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2005 |
Last Update Date | 22/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01465338 | (05) | NY |