Organization
ELLEN PAN MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELLEN PAN M.D. (PRESIDENT)
(718) 236-7772
Entity
Organization
Contact information
Practice address
8301 BAY PKWY, BROOKLYN, NY 11214-2666
(718) 236-7772
Mailing address
8301 BAY PKWY, BROOKLYN, NY 11214-2666
(718) 236-7772
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
136911
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00589708-9
—
NY
Enumeration date
02/14/2011
Last updated
02/14/2011
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