MARY W CHANG (NPI# 1962407718) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962407718 |
| Entity Type | Individual |
| Full Name | MARY W CHANG |
| Credential | MD |
| Practice Address |
65 Memorial Rd Suite 450 West Hartford CT 06107-2434 |
| Practice Telephone | 8605231087 |
| Practice Fax Number | 8605231472 |
| Mailing Telephone | 8605231087 |
| Mailing Fax Number | 8605231472 |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2014-09-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207NP0225X |
Dermatology Specialization: Pediatric Dermatology |
42985 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 001429853 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457885949 | Mary M Chang | Pharmacist | 1200 El Camino Real, South San Francisco, CA 94080-3208 | 2017-04-12 |
| 1942644174 | Mary Chang | Social Worker | 2090 Evans Ln, San Jose, CA 95125-2072 | 2013-04-18 |
| 1558618546 | Mary Pearl Chang | Emergency Medicine | 5323 Harry Hines Blvd, Dallas, TX 75390-7208 | 2012-08-08 |
| 1659470516 | Mary Chang | Chiropractor | 125 16th Ave E, Seattle, WA 98112-5211 | 2006-09-21 |
| 1407870389 | Mary C. Chang | Obstetrics & Gynecology | 2 Water St, Central Plaza, Haverhill, MA 01830-6229 | 2006-07-26 |
| 1134107121 | Mary Ann Chang | Dentist | 9314 E Central Ave, Wichita, KS 67206-2555 | 2006-01-09 |
| Street Address |
65 MEMORIAL RD SUITE 450 |
| City | WEST HARTFORD |
| State | CT |
| Zip Code | 06107-2434 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932619160 | Daniel Jones | Psychologist | 65 Memorial Rd, West Hartford, CT 06107-2434 | 2017-10-02 |
| 1609128016 | Hartford Healthcare Medical Group, Inc | Podiatrist | 65 Memorial Rd, Ste. 430, West Hartford, CT 06107-2434 | 2012-10-09 |
| 1467709097 | Andrea Dias Murphy | Nurse Practitioner | 65 Memorial Rd, Hartford Healthcare Headache Center, West Hartford, CT 06107-2434 | 2012-08-14 |
| 1972883858 | Hartford Clinical Associates, PC | Podiatrist | 65 Memorial Rd, Suite 430, West Hartford, CT 06107-2434 | 2011-08-23 |
| 1598051674 | Elizabeth Dolan Holzhauer | Dentist | 65 Memorial Rd, Suite 400, West Hartford, CT 06107-2434 | 2011-06-27 |
| 1306038674 | Ricardo Taboada | Anesthesiology | 65 Memorial Rd, Suite 435, West Hartford, CT 06107-2434 | 2007-08-10 |
| 1932313863 | Kelly Su Lim | Massage Therapist | 65 Memorial Rd, Suite 410, West Hartford, CT 06107-2434 | 2007-05-10 |
| 1467588343 | Hartford Dermatology Associates PC | Dermatology | 65 Memorial Rd, Suite 450, West Hartford, CT 06107-2434 | 2007-02-26 |
| 1730240839 | Lee David Brauer | Psychiatry & Neurology | 65 Memorial Rd, Suite 440, West Hartford, CT 06107-2434 | 2006-12-12 |
| 1447337050 | Ob-gyn Associates of West Hartford, PC | Obstetrics & Gynecology | 65 Memorial Rd, Suite 550, West Hartford, CT 06107-2434 | 2006-11-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538783659 | Briana Deslauriers | Audiologist | Solinsky Hearing Center, 1013 Farmington Avenue, West Hartford, CT 06107 | 2020-06-04 |
| 1750851366 | Candyce Yvonne Scott | Counselor | 61 S Main St Ste 310, West Hartford, CT 06107 | 2018-11-27 |
| 1124524798 | Image of Light Mental Health Services, LLC | Nurse Practitioner | 45 S Main St Ste 70, West Hartford, CT 06107 | 2018-04-03 |
| 1235632498 | Leila Fussell | Student in an Organized Health Care Education/Training Program | 175 Garfield Rd, West Hartford, CT 06107 | 2018-03-14 |
| 1568818169 | Gail Southard Canzano | Psychologist | 81 S. Main St, West Hartford, CT 06107 | 2016-05-12 |
| 1922470939 | Optimal Wellness of West Hartford | Family Medicine | 1001 Farmington Ave., West Hartford, CT 06107 | 2015-10-29 |
| 1518369925 | Maria Eugenia Garcia-ayala | Psychiatry & Neurology | 65 Memorial Rd Ste 508, West Hartford, CT 06107 | 2014-09-17 |
| 1376884981 | Robert Moss | Pediatrics | 174 Wood Pond Road, West Hartford, CT 06107 | 2013-03-06 |
| 1659630960 | Michael John Grille | Anesthesiology | 65 Memorial Rd #435, Hartford Hospital Pain Treatment Center, West Hartford, CT 06107 | 2012-05-07 |
| 1518268010 | Parsons Health Co. Inc | Legal Medicine | 61 So Main Street, Suite 202, West Hartford, CT 06107 | 2010-11-15 |
| Find all providers in zip 06107 | ||||
| Taxonomy Code | 207NP0225X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Pediatric Dermatology |
| A pediatric dermatologist has, through additional special training, developed expertise in the treatment of specific skin disease categories with emphasis on those diseases which predominate in infants, children and adolescents. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: changed definition, added source] Additional Resources: American Board of Dermatology, 2007, http://www.abderm.org/ A subspecialty certificate was approved by ABMS in 2000. ACGME Accredited Residency Program Requirements: None. |
| City | WEST HARTFORD |
| Zip Code | 06107 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.