Provider Demographics
NPI:1639425689
Name:CHANG, NAI-LUN (MD)
Entity Type:Individual
Prefix:DR
First Name:NAI-LUN
Middle Name:
Last Name:CHANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 GRAND ST STE 401
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4396
Mailing Address - Country:US
Mailing Address - Phone:212-390-1830
Mailing Address - Fax:
Practice Address - Street 1:762 59TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-3936
Practice Address - Country:US
Practice Address - Phone:718-393-5333
Practice Address - Fax:212-335-0320
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-27
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY280722207R00000X, 207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease