Provider Demographics
NPI:1407057110
Name:FLUSHING REHAB MEDICAL, PLLC
Entity Type:Organization
Organization Name:FLUSHING REHAB MEDICAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHI-CHENG
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-939-4166
Mailing Address - Street 1:13329 41ST RD STE 1A
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-3671
Mailing Address - Country:US
Mailing Address - Phone:718-939-4166
Mailing Address - Fax:718-939-4167
Practice Address - Street 1:13329 41ST RD STE 1A
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3671
Practice Address - Country:US
Practice Address - Phone:718-939-4166
Practice Address - Fax:718-939-4167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF26344Medicare UPIN
NY04014Medicare ID - Type Unspecified