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Organization

EVERGREEN FAMILY MEDICAL SERVICES,P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RAYMOND CHAN MD (MEDICAL DIRETOR)
(718) 765-0088
Entity
Organization

Contact information

Practice address
743 58TH ST, BROOKLYN, NY 11220-3916
(718) 765-0088
(718) 567-8208
Mailing address
743 58TH ST, BROOKLYN, NY 11220-3916
(718) 765-0088
(718) 567-8208

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02720354
NY
Enumeration date
02/26/2006
Last updated
10/01/2012
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