Individual
TINA CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
128 MOTT ST, SUITE 303, NEW YORK, NY 10013-5540
(212) 966-7583
Mailing address
1521 W 7TH ST, BROOKLYN, NY 11204-6508
(917) 733-6531
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV007572-1
NY
Other
Enumeration date
08/16/2010
Last updated
08/16/2010
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