Provider Demographics
NPI:1982927000
Name:CHANG, SU WEI (BS)
Entity Type:Individual
Prefix:MS
First Name:SU
Middle Name:WEI
Last Name:CHANG
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1982 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6335
Mailing Address - Country:US
Mailing Address - Phone:212-831-1000
Mailing Address - Fax:212-831-1019
Practice Address - Street 1:1982 2ND AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6335
Practice Address - Country:US
Practice Address - Phone:212-831-1000
Practice Address - Fax:212-831-1019
Is Sole Proprietor?:No
Enumeration Date:2010-03-03
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042816183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist