Individual
CHANGYONG SHIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7 W 30TH ST, NEW YORK, NY 10001-4406
(212) 725-7850
Mailing address
41 CONFORTI AVE, WEST ORANGE, NJ 07052-2824
(973) 307-7576
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
01/20/2022
Last updated
01/20/2022
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