Individual
TYLER CHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7901 BROADWAY, ELMHURST, NY 11373-1329
(718) 334-1419
(718) 334-5006
Mailing address
7901 BROADWAY, ELMHURST, NY 11373-1329
(718) 334-1419
(718) 334-5006
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
024876
NY
Other
Enumeration date
10/18/2019
Last updated
04/23/2020
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