Individual
CHAN ANDRIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
114 WOODLAND ST, SURGERY DEPT, HARTFORD, CT 06105-1208
(860) 714-5237
Mailing address
1000 ASYLUM AVE, SUITE 2109A, HARTFORD, CT 06105-1770
(860) 714-6581
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
002002
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003020021
—
CT
Enumeration date
10/22/2007
Last updated
12/18/2013
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