Organization
IAN CHAN MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IAN CHAN MD (PRESIDENT)
(631) 213-1668
Entity
Organization
Contact information
Practice address
139 CENTRE ST PH 113, NEW YORK, NY 10013
(631) 213-1668
(718) 509-6993
Mailing address
139 CENTRE ST PH 113, NEW YORK, NY 10013-4559
(631) 213-1668
Taxonomy
Speciality
Code
Description
License number
State
261QS0132X
Ophthalmologic Surgery Clinic/Center
Primary
249201
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03580976
—
NY
Enumeration date
04/28/2013
Last updated
09/03/2018
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