Chan, Kyle

Chan, Kyle is an individual health care provider with primary practice located at 2510 30Th Ave , Long Island City NY 11102-2448. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Chan, Kyle can be contacted via phone (718) 267-4390.

Contact Information

Primary practice address
2510 30Th Ave Long Island City NY 11102-2448
Phone: (718) 267-4390
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 005143 New York

Profile Details

NPI number 1720016983
LBN Legal business name Chan, Kyle
Credentials P.A.C.
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 28th, 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 1720016983 NPPES
New York MEDICAID 2165320

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