Most Relevant Information
Provider Data
| NPI Number: | 1003402298 |
| Provider Name: | BOB CHANG |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | 046782 |
Most Important Dates
| Enumeration Date: | 12/12/2020 |
| Last Updated: | 03/23/2023 |
Provider Practice Location
1991 MARCUS AVE
NEW HYDE PARK
NY
110422057
Practice Location Phone/Fax
| Phone: | 5164678730 |
| Fax: |
Provider Mailing Location
1377 MOTOR PKWY STE 307
ISLANDIA
NY
117495258
Provider Mailing Phone/Fax
| Phone: | 9142944050 |
| Fax: |