Provider Demographics
NPI:1386861995
Name:ALEXANDER CHANG MD PC
Entity Type:Organization
Organization Name:ALEXANDER CHANG MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:E
Authorized Official - Last Name:BENARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-429-2020
Mailing Address - Street 1:2101 GREENTREE RD STE 105
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15220-1400
Mailing Address - Country:US
Mailing Address - Phone:412-429-2020
Mailing Address - Fax:412-429-0932
Practice Address - Street 1:2101 GREENTREE RD STE 105
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15220-1400
Practice Address - Country:US
Practice Address - Phone:412-429-2020
Practice Address - Fax:412-429-0932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA152W00000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018699240001Medicaid
PACN5293OtherMEDICARE RET RAIL
PA0018699240001Medicaid