Individual
SUSANA CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
387 WATERMAN AVE, EAST PROVIDENCE, RI 02914-2618
(401) 453-5800
(401) 271-6867
Mailing address
387 WATERMAN AVE, EAST PROVIDENCE, RI 02914-2618
(401) 453-5800
(401) 271-6867
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODTG00518
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000032701
BRUE CROSS
RI
01
—
23-77354
UNITED HEALTHCARE
—
01
—
32425
NIEGHBORHOOD HEALTH PLAN
RI
01
—
414188
BLUE CROSS
RI
05
—
9082077
—
RI
Enumeration date
02/21/2007
Last updated
06/10/2024
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