Provider Demographics
NPI:1245633825
Name:CHANG, CELESTE SHARON (MD, FACP)
Entity type:Individual
Prefix:DR
First Name:CELESTE
Middle Name:SHARON
Last Name:CHANG
Suffix:
Gender:F
Credentials:MD, FACP
Other - Prefix:DR
Other - First Name:YU
Other - Middle Name:MEI
Other - Last Name:CHANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, FACP
Mailing Address - Street 1:139 CENTRE ST STE 703
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4557
Mailing Address - Country:US
Mailing Address - Phone:212-966-0808
Mailing Address - Fax:212-966-0880
Practice Address - Street 1:139 CENTRE ST STE 703
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4557
Practice Address - Country:US
Practice Address - Phone:212-966-0808
Practice Address - Fax:212-966-0880
Is Sole Proprietor?:No
Enumeration Date:2014-09-26
Last Update Date:2018-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY228743207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology