Individual
DIANA CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
26 BROAD ST, NEW YORK, NY 10005-1904
(646) 512-8215
Mailing address
250 E 30TH ST APT 10A, NEW YORK, NY 10016-8298
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
060819
NY
Other
Enumeration date
01/23/2019
Last updated
04/26/2022
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