Chan, Bernadette

Chan, Bernadette is an individual health care provider with primary practice located at 170 Governors Ave Prompt Care - Lawrence Memorial Hospital, Medford MA 02155-1643. She recently has only one registered license in Allopathic & Osteopathic Physicians / Gynecology, which is considered as her primary health care specialty. Chan, Bernadette can be contacted via phone (781) 306-6103.

Contact Information

Primary practice address
170 Governors Ave Prompt Care - Lawrence Memorial Hospital Medford MA 02155-1643
Phone: (781) 306-6103
Fax: (781) 306-6206
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gynecology 207VG0400X 60545 Massachusetts

Profile Details

NPI number 1235129750
LBN Legal business name Chan, Bernadette
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 26th, 2005
Last updated Apr 27th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235129750 NPPES
Massachusetts MEDICAID 1200992

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