Organization
SHIH-HAN CHAN MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BONNIE OMEDES (OFFICE MANAGER)
(631) 271-9151
Entity
Organization
Contact information
Practice address
1 HEWITT SQ, SUITE 146, EAST NORTHPORT, NY 11731-2519
(631) 271-9151
(631) 271-9155
Mailing address
1 HEWITT SQ, SUITE 146, EAST NORTHPORT, NY 11731-2519
(631) 271-9151
(631) 271-9155
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
253140-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
253140-1
LICENSE
NY
Enumeration date
12/20/2012
Last updated
03/04/2013
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