Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | MD452258 | PA |
N | 207QG0300X | Family Doctor - Geriatric Medicine | MD452258 | PA |
NPI | 1306133350 |
---|---|
Provider Name | Dr. Janice Chan |
First Address | Pittsburgh, PA 15224-1779 |
Second Address | Sarver, PA 16055-9751 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2011 |
Last Update Date | 09/10/2020 |