Provider Demographics
NPI:1073698551
Name:CHIANG, KOU-CHENG
Entity Type:Individual
Prefix:
First Name:KOU-CHENG
Middle Name:
Last Name:CHIANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:KEVIN
Other - Middle Name:
Other - Last Name:CHIANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:140-75 ASH AVE.
Mailing Address - Street 2:7B
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-2791
Mailing Address - Country:US
Mailing Address - Phone:917-660-7889
Mailing Address - Fax:347-905-9902
Practice Address - Street 1:150 GREENWAY TER
Practice Address - Street 2:28 E
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-1025
Practice Address - Country:US
Practice Address - Phone:201-967-9257
Practice Address - Fax:718-880-2920
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY162059207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology