Provider Demographics
NPI:1518394709
Name:CHANG, HWAN SHYANG
Entity Type:Individual
Prefix:MR
First Name:HWAN SHYANG
Middle Name:
Last Name:CHANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3907 PRINCE ST
Mailing Address - Street 2:SUITE 5B
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-5357
Mailing Address - Country:US
Mailing Address - Phone:718-359-5676
Mailing Address - Fax:718-359-3816
Practice Address - Street 1:3907 PRINCE ST
Practice Address - Street 2:SUITE 5B
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5357
Practice Address - Country:US
Practice Address - Phone:718-359-5676
Practice Address - Fax:718-359-3816
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005032-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist