Individual
WOOTAEK CHANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
121 DEKALB AVE, BROOKLYN, NY 11201-5425
(718) 250-8022
(718) 250-6179
Mailing address
50 WOODLAND RD, ROSLYN, NY 11576-1434
(516) 365-1822
(718) 250-6179
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
171373
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01153222
—
NY
Enumeration date
08/04/2006
Last updated
08/09/2013
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