Individual
BRIAN YISHING CHANGLAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4921 BRIARWOOD LN, MANLIUS, NY 13104-1307
(315) 637-5986
(315) 632-4426
Mailing address
4921 BRIARWOOD LN, MANLIUS, NY 13104-1307
(315) 637-5986
(315) 632-4426
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
147291
NY
207RC0000X
Cardiovascular Disease Physician
147291
NY
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
147291
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00922303
—
NY
Enumeration date
11/22/2005
Last updated
11/26/2012
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