Provider Demographics
NPI:1255309613
Name:CHUNG, CHIA-YANG (OTR)
Entity Type:Individual
Prefix:MR
First Name:CHIA-YANG
Middle Name:
Last Name:CHUNG
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 OAKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11552-1940
Mailing Address - Country:US
Mailing Address - Phone:516-205-0529
Mailing Address - Fax:516-564-6864
Practice Address - Street 1:70 OAKLAND AVE
Practice Address - Street 2:
Practice Address - City:WEST HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11552-1940
Practice Address - Country:US
Practice Address - Phone:516-205-0529
Practice Address - Fax:516-564-6864
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008113-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist