Provider Demographics
NPI:1538460159
Name:CHANG, CONSTANCE T (NP)
Entity type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:T
Last Name:CHANG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1068
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-5068
Mailing Address - Country:US
Mailing Address - Phone:610-871-7200
Mailing Address - Fax:610-871-6210
Practice Address - Street 1:2185 GALLOWAY RD
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-2983
Practice Address - Country:US
Practice Address - Phone:610-871-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-12
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY336554363LF0000X
RIAPRN00588363LF0000X, 363LP2300X
RINPP37634363LF0000X
MARN2292523363LF0000X
PASP024146363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care