Individual
DR. ENOCH CHUNG CHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1461 LAKELAND AVE UNIT 14, BOHEMIA, NY 11716-2174
(631) 218-8800
(631) 218-8801
Mailing address
1461 LAKELAND AVE UNIT 14, BOHEMIA, NY 11716-2174
(631) 218-8800
(631) 218-8801
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
200300
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01837470
—
NY
01
—
1356309603
UNITED HEALTHCARE
NY
Enumeration date
05/03/2006
Last updated
08/28/2008
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