Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | MD448141 | PA |
Y | 208600000X | Surgeon | MD448141 | PA |
N | 2086S0102X | Surgical Critical Care | 273137 | NY |
N | 2086S0127X | Trauma Surgeon | 273137 | NY |
NPI | 1144518697 |
---|---|
Provider Name | Dr. Edward Chao |
First Address | Bronx, NY 10461-1138 |
Second Address | Bronx, NY 10461-1138 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2011 |
Last Update Date | 20/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
102949620 | (05) | PA |