Individual
MR. DEREK TSAI SHANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
269 01 76TH AVE, QUEENS, NY 11040
(718) 470-7640
Mailing address
269 01 76TH AVE, QUEENS, NY 11040
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
SP021159
PA
Other
Enumeration date
11/14/2019
Last updated
03/25/2022
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