Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | 2701291 | NY |
NPI | 1457793838 |
---|---|
Provider Name | Dr. Lai-Ming Lisa Chan |
First Address | Valhalla, NY 10595-1524 |
Second Address | Valhalla, NY 10595-1524 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2013 |
Last Update Date | 04/03/2015 |