Individual
MICHELLE JIMENEZ CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
327 BEACH 19TH ST, FAR ROCKAWAY, NY 11691-4423
(718) 869-7755
Mailing address
2 GOLD ST APT 1514, NEW YORK, NY 10038-4847
(321) 482-7779
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
431408
NY
Other
Enumeration date
01/06/2019
Last updated
01/06/2019
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