Provider Demographics
NPI:1598901233
Name:METROPOLITAN CARDIOLOGY GROUP,LLP
Entity Type:Organization
Organization Name:METROPOLITAN CARDIOLOGY GROUP,LLP
Other - Org Name:JOON K. CHANG, MD
Other - Org Type:Other Name
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOON
Authorized Official - Middle Name:KYU
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-735-7576
Mailing Address - Street 1:193 CRABAPPLE RD
Mailing Address - Street 2:
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-1710
Mailing Address - Country:US
Mailing Address - Phone:201-256-6088
Mailing Address - Fax:201-606-8257
Practice Address - Street 1:15 VERVALEN ST
Practice Address - Street 2:KOREAN MEDICAL CENTER
Practice Address - City:CLOSTER
Practice Address - State:NJ
Practice Address - Zip Code:07624-2635
Practice Address - Country:US
Practice Address - Phone:201-735-7576
Practice Address - Fax:201-606-8257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-31
Last Update Date:2008-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05899200207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2190054Medicaid
NY2190054Medicaid
NY422P31Medicare PIN