Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 014663 | NY |
NPI | 1003051665 |
---|---|
Provider Name | Jihee Chang |
First Address | Flushing, NY 11354-3197 |
Second Address | Flushing, NY 11354-3197 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/12/2008 |
Last Update Date | 26/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00246075 | (05) | NY |
04956598 | (05) | NY |