Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | N003901 | NY |
Y | 222Z00000X | Podiatrist | N003901 | NY |
N | 213EP0504X | Public Medicine | N003901 | NY |
N | 213EP1101X | Primary Podiatric Medicine | N003901 | NY |
N | 111NR0200X | Radiology | N003901 | NY |
N | 213ER0200X | Radiology | N003901 | NY |
N | 213ES0131X | Foot Surgery | N003901 | NY |
NPI | 1700831518 |
---|---|
Provider Name | Dr. Collier Chan |
First Address | Elmhurst, NY 11373-4575 |
Second Address | Elmhurst, NY 11373-4575 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2006 |
Last Update Date | 27/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T84821 | (02) | NY |