Provider Demographics
NPI:1639541188
Name:HSIAO, CHAO (RD, CDE, CDN)
Entity Type:Individual
Prefix:
First Name:CHAO
Middle Name:
Last Name:HSIAO
Suffix:
Gender:F
Credentials:RD, CDE, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3551 158TH ST
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358
Mailing Address - Country:US
Mailing Address - Phone:917-822-3222
Mailing Address - Fax:
Practice Address - Street 1:3551 158TH ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-1616
Practice Address - Country:US
Practice Address - Phone:917-822-3222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-23
Last Update Date:2015-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY958232133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered