Chang, Mary W
Chang, Mary W is an individual health care provider with primary practice located at Uconn Dermatology 21 South Road, 2Nd Floor, Farmington CT 06032. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Dermatology, which is considered as her primary health care specialty. Chang, Mary W can be contacted via phone (860) 679-4600.Contact Information
Primary practice address
Uconn Dermatology 21 South Road, 2Nd Floor
Farmington CT 06032
Phone: (860) 679-4600
Fax: (860) 679-7534
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Dermatology | 207NP0225X | 42985 | Connecticut |
Profile Details
| NPI number | 1962407718 |
|---|---|
| LBN Legal business name | Chang, Mary W |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 17th, 2005 |
| Last updated | Sep 30th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1962407718 | NPPES |
| Connecticut | MEDICAID | 001429853 |
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