Provider Demographics
NPI:1073665873
Name:CHAO, PAULINE YUEN (MD)
Entity Type:Individual
Prefix:DR
First Name:PAULINE
Middle Name:YUEN
Last Name:CHAO
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 1:49 WALPOLE ST STE 1
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-3341
Mailing Address - Country:US
Mailing Address - Phone:781-762-4199
Mailing Address - Fax:
Practice Address - Street 1:49 WALPOLE ST STE 1
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-3341
Practice Address - Country:US
Practice Address - Phone:781-762-4199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA44366207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAB72846Medicare UPIN
MAB11647Medicare ID - Type Unspecified