Individual
GILBERT LAVARIAS CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
145 DREISER LOOP, BRONX, NY 10475-2704
(718) 671-2955
(888) 583-1385
Mailing address
120 NEWHAM AVE, BRENTWOOD, NY 11717-5624
(631) 813-2143
(888) 552-6176
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
028152
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A400105691
NGS MEDICARE
NY
Enumeration date
07/14/2006
Last updated
03/22/2018
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