Chan, Jacqueline

Chan, Jacqueline is an individual health care provider with primary practice located at 139 Centre St Suite 307, New York NY 10013-4552. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Nuclear Imaging & Therapy, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Cardiovascular Disease is her primary health care specialty. Chan, Jacqueline can be contacted via phone (212) 334-3507.

Contact Information

Primary practice address
139 Centre St Suite 307 New York NY 10013-4552
Fax: (212) 334-4728
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nuclear Imaging & Therapy 207UN0902X 246413 New Mexico
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 246413 New York

Profile Details

NPI number 1992931299
LBN Legal business name Chan, Jacqueline
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 2nd, 2009
Last updated Nov 20th, 2018 - about 7 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 1992931299 NPPES
New York MEDICAID 03350121

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