Individual
DR. SAMUEL S CHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
202 CANAL ST, SUITE 801, NEW YORK, NY 10013-4517
(212) 406-2301
(212) 406-2359
Mailing address
202 CANAL ST, SUITE 801, NEW YORK, NY 10013-4517
(212) 406-2301
(212) 406-2359
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
193850-1
NY
246XC2901X
Cardiovascular Invasive Specialist/Technologist
Primary
193850-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01617692
MEDICAID-INDIVIDUAL PROVIDER
NY
01
—
03543166
MEDICAID-GROUP PROVIDER (DOCTOR CHAN MEDICAL PRACTICE, PC)
NY
01
—
1376729426
NPI-GROUP ORGANIZATION
NY
01
—
1841253267
NPI-INDIVIDUAL PROVIDER
NY
Enumeration date
04/07/2006
Last updated
06/23/2017
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