Individual
COREY CHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
550 LYNN ST, RIDGEWOOD, NJ 07450
(201) 602-2945
Mailing address
550 LYNN ST, RIDGEWOOD, NJ 07450
(201) 602-2945
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
026226
NY
Other
Enumeration date
04/16/2019
Last updated
09/29/2022
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