Provider Demographics
NPI:1144376039
Name:CHIN, GYU SANG (MD,)
Entity Type:Individual
Prefix:DR
First Name:GYU
Middle Name:SANG
Last Name:CHIN
Suffix:
Gender:M
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10420 QUEENS BLVD
Mailing Address - Street 2:APT 7X
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-3629
Mailing Address - Country:US
Mailing Address - Phone:718-896-4344
Mailing Address - Fax:
Practice Address - Street 1:10420 QUEENS BLVD
Practice Address - Street 2:APT 7X
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-3629
Practice Address - Country:US
Practice Address - Phone:718-883-4640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY242838208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery