Provider Demographics
NPI:1073619490
Name:CHIANG, ANNE C (MD)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:C
Last Name:CHIANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 YORK ST
Mailing Address - Street 2:NP15-304
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-3220
Mailing Address - Country:US
Mailing Address - Phone:203-200-1689
Mailing Address - Fax:
Practice Address - Street 1:200 YORK STREET, NP15-304
Practice Address - Street 2:YALE UNIVERSITY SCHOOL OF MEDICINE
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06520
Practice Address - Country:US
Practice Address - Phone:203-200-5864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT046835207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00743966OtherRAILROAD MEDICARE PART B
CT046835OtherCT LICENSE
046835OtherCONNECTICARE
7256864OtherAETNA
CT008002184Medicaid
CT0044197OtherCT CONTROLLED SUBSTANCE
1073619490OtherNPI
1246972OtherCIGNA
BC9700798OtherDEA
1246972OtherCIGNA
H63003Medicare UPIN