Provider Demographics
NPI:1730187543
Name:SHIM- CHANG, HELEN (MD)
Entity type:Individual
Prefix:DR
First Name:HELEN
Middle Name:
Last Name:SHIM- CHANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 E 98TH ST FL 5
Mailing Address - Street 2:MOUNT SINAI MEDICAL CENTER, DEPT OF DERMATOLOGY
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6501
Mailing Address - Country:US
Mailing Address - Phone:212-241-9728
Mailing Address - Fax:212-987-1197
Practice Address - Street 1:5 E 98TH ST FL 5
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6501
Practice Address - Country:US
Practice Address - Phone:212-241-3050
Practice Address - Fax:212-987-1197
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-14
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY192475207ND0900X, 207ZP0101X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH11947Medicare UPIN
NY12U371Medicare ID - Type Unspecified