Individual provider Active NPI

Amy Chang, MA, CCC-SLP, TSHH

  • Speech-Language Pathologist
  • Mohegan Lake, NY
National Provider Identifier
1396998951
Registry record updated Oct 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
014806-01 Issued in NY
Practice address
421 Panorama Dr
Mohegan Lake, NY 10547-1205
Phone
(718) 483-2258
NPI assigned
Oct 28, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 014806-01 NY Primary

Addresses

Primary practice location

421 Panorama Dr
Mohegan Lake, NY 10547-1205

Mailing address

421 Panorama Dr
Mohegan Lake, NY 10547-1205

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)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
014806-01NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225152000000",
    "number": "1396998951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 PANORAMA DR",
            "city": "MOHEGAN LAKE",
            "state": "NY",
            "postal_code": "105471205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 PANORAMA DR",
            "city": "MOHEGAN LAKE",
            "state": "NY",
            "postal_code": "105471205",
            "telephone_number": "718-483-2258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "AMY",
        "credential": "MA, CCC-SLP, TSHH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-28",
        "last_updated": "2008-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "014806-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mohegan Lake, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; 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.