Individual
CHUN-YU FAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4370 KISSENA BLVD, FLUSHING, NY 11355-3769
(408) 768-7098
Mailing address
4370 KISSENA BLVD, FLUSHING, NY 11355-3769
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
057902
NY
Other
Enumeration date
05/08/2014
Last updated
11/03/2015
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