Individual
DR. WALLEN CY CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
78 TODT HILL RD, STATEN ISLAND, NY 10314-4528
(718) 448-1122
(718) 448-8318
Mailing address
4 AIRDALE DR, KENDALL PARK, NJ 08824-1494
(718) 448-1122
(718) 448-8318
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
183203
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01768538
—
NY
Enumeration date
03/01/2006
Last updated
04/14/2008
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