Provider Demographics
NPI:1386497378
Name:CHANG, ANGELA
Entity type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:
Last Name:CHANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 LEYDEN ST APT 3
Mailing Address - Street 2:
Mailing Address - City:EAST BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02128-3930
Mailing Address - Country:US
Mailing Address - Phone:757-209-1314
Mailing Address - Fax:
Practice Address - Street 1:1 PIER 7 STE 140
Practice Address - Street 2:
Practice Address - City:CHARLESTOWN
Practice Address - State:MA
Practice Address - Zip Code:02129-4225
Practice Address - Country:US
Practice Address - Phone:617-724-5202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program