Provider Demographics
NPI:1063586006
Name:CHIANG, JIH-LIH (MD)
Entity type:Individual
Prefix:
First Name:JIH-LIH
Middle Name:
Last Name:CHIANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 ARLEIGH RD
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021
Mailing Address - Country:US
Mailing Address - Phone:516-482-5305
Mailing Address - Fax:
Practice Address - Street 1:13620 38TH AVE
Practice Address - Street 2:STE 8E
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-4233
Practice Address - Country:US
Practice Address - Phone:718-445-2581
Practice Address - Fax:718-445-2581
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNY158250207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00852286Medicaid
677734103Medicare ID - Type Unspecified
NY00852286Medicaid