Chang, Wootaek
Chang, Wootaek is an sole proprietor health care provider with primary practice located at 121 Dekalb Ave , Brooklyn NY 11201-5425. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Chang, Wootaek can be contacted via phone (718) 250-8022.Contact Information
Primary practice address
121 Dekalb Ave
Brooklyn NY 11201-5425
Phone: (718) 250-8022
Fax: (718) 250-6179
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | 171373 | New York |
Profile Details
| NPI number | 1437167590 |
|---|---|
| LBN Legal business name | Chang, Wootaek |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 4th, 2006 |
| Last updated | Aug 9th, 2013 - about 12 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 | 1437167590 | NPPES |
| New York | MEDICAID | 01153222 |
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