Individual
GRACE CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
525 EAST 68TH ST, PAYSON 5, NEW YORK, NY 10065
(646) 962-5757
Mailing address
525 EAST 68TH ST, PAYSON 5, NEW YORK, NY 10065
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F307708
NY
363LA2200X
Adult Health Nurse Practitioner
F307708-1
NY
Other
Enumeration date
03/18/2015
Last updated
08/17/2023
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