Provider Demographics
NPI:1225197080
Name:WOO, CHANG W (DC)
Entity Type:Individual
Prefix:DR
First Name:CHANG
Middle Name:W
Last Name:WOO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8908 ROOSEVELT AVE
Mailing Address - Street 2:2ND FLOOOR
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-7857
Mailing Address - Country:US
Mailing Address - Phone:718-424-1454
Mailing Address - Fax:718-424-1412
Practice Address - Street 1:8908 ROOSEVELT AVE
Practice Address - Street 2:2ND FLOOOR
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-7857
Practice Address - Country:US
Practice Address - Phone:718-424-1454
Practice Address - Fax:718-424-1412
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010435111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor