Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 2068741 | NY |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 25MA05936800 | NJ |
NPI | 1174557979 |
---|---|
Provider Name | Ying Chan |
First Address | Flushing, NY 11355-3666 |
Second Address | Flushing, NY 11355-3666 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 13/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
08199783 | (05) | NY |
8422206 | (05) | NJ |
G17952 | (02) |