Individual
ANGIE CHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 NESCONSET HWY BLDG 20B, STONY BROOK, NY 11790-2563
(631) 864-6647
Mailing address
2500 NESCONSET HWY BLDG 20B, STONY BROOK, NY 11790-2563
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
02/21/2022
Last updated
02/10/2023
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