Individual
LORI CHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
20220 36TH AVE, BAYSIDE, NY 11361-1158
(917) 513-0588
Mailing address
20220 36TH AVE, BAYSIDE, NY 11361-1158
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86210199
—
Other
Enumeration date
03/20/2023
Last updated
04/11/2023
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