Provider Demographics
NPI:1609985506
Name:CHI, CHUANXIANG (MD)
Entity Type:Individual
Prefix:DR
First Name:CHUANXIANG
Middle Name:
Last Name:CHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 GREENWAY SOUTH
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-5912
Mailing Address - Country:US
Mailing Address - Phone:718-651-5713
Mailing Address - Fax:718-651-5714
Practice Address - Street 1:34 GREENWAY S
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-5943
Practice Address - Country:US
Practice Address - Phone:718-651-5713
Practice Address - Fax:718-651-5714
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY227282208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0495J1Medicare ID - Type Unspecified
H99826Medicare UPIN