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Individual

DR. JOHNNY A. CHANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
410 SAYBROOK RD, MIDDLETOWN, CT 06457-4777
(860) 358-2270
(860) 358-2275
Mailing address
28 CRESCENT ST, MIDDLETOWN, CT 06457-3650
(860) 358-6000
(860) 358-8661

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
041177
CT
208800000X
Urology Physician
Primary
041177
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000231610801
UNITED HEALTHCARE ID
CT
01
00141177700
BLUE CARE FAMILY PLAN ID
CT
01
010041177CT01
BLUE SHIELD PROVIDER ID
CT
01
041177
CONNECTICARE PROVIDER ID
CT
05
1411777
CT
01
2V4421
HEALTHNET PROVIDER ID
CT
01
3159551
AETNA PROVIDER ID
CT
01
P2882366
OXFORD PROVIDER ID
CT
Enumeration date
07/08/2005
Last updated
05/05/2026
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