Individual
DR. KATHLEEN CHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
51 CROWN ST APT 205, NEW HAVEN, CT 06510-3334
(203) 785-2802
Mailing address
PO BOX 100254, GAINESVILLE, FL 32610-0254
(352) 273-8870
(352) 273-8612
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME132440
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/12/2014
Last updated
06/30/2017
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