Individual
MIMI CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
600 ROE AVE # 1A, ELMIRA, NY 14905-1629
(607) 737-4130
Mailing address
571 SAINT JOSEPHS BLVD FL 2, ELMIRA, NY 14901-3230
(607) 271-2094
(607) 271-2071
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
347650
NY
Other
Enumeration date
04/30/2021
Last updated
04/30/2021
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