Chan, Kimberley W.

Chan, Kimberley W. is an individual health care provider with primary practice located at 243 Charles St , Boston MA 02114-3002. She recently has only one registered license in Eye and Vision Services Providers / Pediatrics, which is considered as her primary health care specialty. Chan, Kimberley W. can be contacted via phone (617) 573-4169.

Contact Information

Primary practice address
243 Charles St Boston MA 02114-3002
Phone: (617) 573-4169
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Pediatrics 152WP0200X 4522 Massachusetts

Profile Details

NPI number 1104908458
LBN Legal business name Chan, Kimberley W.
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 19th, 2006
Last updated Jul 8th, 2007 - about 17 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 1104908458 NPPES
Massachusetts Other W16452 BCBS PROVIDER ID

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