Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 284241 | MA |
N | 207Q00000X | Family Doctor | D63000 | MD |
NPI | 1003853508 |
---|---|
Provider Name | Dr. Sylvia S Chang |
First Address | Waban, MA 02468-1205 |
Second Address | Burlington, MA 01803-4945 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2006 |
Last Update Date | 18/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
102253 | JOHNS HOPKINS EHP (01) | MD |
102253 | PRIORITY PARTNERS (01) | MD |
1075803 | AETNA HMO (01) | MD |
2822930 | CIGNA (01) | MD |
408387300 | (05) | MD |
7532160 | AETNA NON HMO (01) | MD |
H17050 | (02) | |
KJ24GB/647103-01 | CAREFIRST MARYLAND (01) | MD |
KJ24GB/P16885 | CAREFIRST POS (01) | MD |
S142/0019 | CAREFIRST REGIONAL (01) | MD |