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Organization
LAURA CHAN, NURSE PRACTITIONER-PSYCHIATRY, P.C.
Active
Organization
LAURA CHAN, NURSE PRACTITIONER-PSYCHIATRY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA CHAN (OWNER)
(516) 524-2031
Entity
Organization
Contact information
Practice address
646 MAIN ST, SUITE 201, PORT JEFFERSON, NY 11777-2235
(631) 524-2031
Mailing address
646 MAIN ST, SUITE 201, PORT JEFFERSON, NY 11777-2235
(631) 524-2031
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/18/2011
Last updated
07/18/2011
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