Individual
DR. JASON L CHANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
55 MERIDEN AVE STE 1A, SOUTHINGTON, CT 06489-3237
(860) 621-9316
Mailing address
55 MERIDEN AVE STE 1A, SOUTHINGTON, CT 06489-3237
(860) 621-9316
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
049717
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
204892866
TAXPAYER IDENTIFICATION
—
Enumeration date
05/15/2007
Last updated
08/01/2012
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