Provider Demographics
NPI:1902066574
Name:LE & CHANG FAMILY URGENT CARE PC
Entity Type:Organization
Organization Name:LE & CHANG FAMILY URGENT CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:QUANG
Authorized Official - Middle Name:PHONG
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-685-1517
Mailing Address - Street 1:569 WATER ST
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-7651
Mailing Address - Country:US
Mailing Address - Phone:508-494-6634
Mailing Address - Fax:508-877-0596
Practice Address - Street 1:456 PARK AVE
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01610-1227
Practice Address - Country:US
Practice Address - Phone:508-685-1517
Practice Address - Fax:508-877-0596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-16
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA221724208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty