Chan, Susana K

Chan, Susana K is an individual health care provider with primary practice located at 7206 Northern Blvd , Jackson Heights NY 11372-1049. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Chan, Susana K can be contacted via phone (866) 670-6824.

Contact Information

Primary practice address
7206 Northern Blvd Jackson Heights NY 11372-1049
Phone: (866) 670-6824
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 010893 New York

Profile Details

NPI number 1114004744
LBN Legal business name Chan, Susana K
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 1st, 2006
Last updated Dec 13th, 2022 - about 2 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 1114004744 NPPES
New York MEDICAID 00246075

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