Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | 169930 | NY |
NPI | 1558441071 |
---|---|
Provider Name | Samrang K Kchao |
First Address | New York, NY 10087-9889 |
Second Address | Brooklyn, NY 11213-1122 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 29/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01162289 | (05) | NY |
F87374 | (02) | NY |