Provider Demographics
NPI:1982791844
Name:CHUANG, LINO ONG (PT)
Entity Type:Individual
Prefix:MR
First Name:LINO
Middle Name:ONG
Last Name:CHUANG
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 E PULASKI RD
Mailing Address - Street 2:SUITE C, LOWER LEVEL
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-1915
Mailing Address - Country:US
Mailing Address - Phone:631-396-1595
Mailing Address - Fax:631-396-1597
Practice Address - Street 1:180 E PULASKI RD
Practice Address - Street 2:SUITE C, LOWER LEVEL
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-1915
Practice Address - Country:US
Practice Address - Phone:631-396-1595
Practice Address - Fax:631-396-1597
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009579-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY650025893OtherRAILROAD MEDICARE
NY650025894OtherRAILROAD MEDICARE
NY01267129Medicaid
NY05069GMedicare PIN
NY01267129Medicaid