Individual
CHAN M MA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
128 MOTT ST, SUITE 405, NEW YORK, NY 10013-5540
(212) 966-0068
(212) 966-0072
Mailing address
7705 SHORE ROAD, BROOKLYN, NY 11209
(718) 715-8674
(212) 966-0072
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
180042
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01608846
—
NY
Enumeration date
10/06/2005
Last updated
03/19/2025
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