Individual provider Active NPI

Yujin Song Chang, MSPT

  • Physical Therapist
  • Englewood, NJ
National Provider Identifier
1043414972
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01141100 Issued in NJ
Practice address
100 E Palisade Ave
Apt. D-12
Englewood, NJ 07631-3046
Phone
(201) 838-5390
NPI assigned
Jun 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA01141100 NJ Primary

Addresses

Primary practice location

100 E Palisade Ave
Apt. D-12
Englewood, NJ 07631-3046

Mailing address

100 E Palisade Ave
Apt. D-12
Englewood, NJ 07631-3046
Phone (201) 838-5390

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043414972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E PALISADE AVE",
            "address_2": "APT. D-12",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076313046",
            "telephone_number": "201-838-5390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E PALISADE AVE",
            "address_2": "APT. D-12",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076313046",
            "telephone_number": "201-838-5390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "YUJIN",
        "middle_name": "SONG",
        "name_prefix": "Mrs.",
        "credential": "MSPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01141100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.