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Individual

DR. PEGGY CHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
360 BARD AVE, STATEN ISLAND, NY 10310-1666
(718) 876-2000
(718) 876-2006
Mailing address
360 BARD AVE, STATEN ISLAND, NY 10310-1666
(718) 876-2000
(718) 876-2006

Taxonomy

Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
036168022
IL
207U00000X
Nuclear Medicine Physician
Primary
233455
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02685490
NY
Enumeration date
11/22/2005
Last updated
03/04/2025
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