Basic Information
Provider Information
NPI: 1033370028
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHAO
FirstName: STEVEN
MiddleName: YEH-GENG
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5645 MAIN ST
Address2: W-LL300
City: FLUSHING
State: NY
PostalCode: 113555045
CountryCode: US
TelephoneNumber: 7184450220
FaxNumber: 7189391167
Practice Location
Address1: 5645 MAIN ST
Address2: W-LL300
City: FLUSHING
State: NY
PostalCode: 113555045
CountryCode: US
TelephoneNumber: 7184450220
FaxNumber: 7189391167
Other Information
ProviderEnumerationDate: 06/23/2008
LastUpdateDate: 08/25/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000XLP01469RIN Allopathic & Osteopathic PhysiciansSurgery 
208600000XMD14237RIN Allopathic & Osteopathic PhysiciansSurgery 
208600000X2860136NYY Allopathic & Osteopathic PhysiciansSurgery 

No ID Information.


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