Provider Demographics
NPI:1013746668
Name:SHAO, CHUNYING (NP)
Entity type:Individual
Prefix:
First Name:CHUNYING
Middle Name:
Last Name:SHAO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9860 62ND RD BSMT
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-1455
Mailing Address - Country:US
Mailing Address - Phone:909-572-9196
Mailing Address - Fax:
Practice Address - Street 1:3808 UNION ST STE 6B
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5672
Practice Address - Country:US
Practice Address - Phone:718-888-1125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-31
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY311887363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner