Fan, Pang-Yen

Fan, Pang-Yen is an individual health care provider with primary practice located at 55 Lake Ave N , Worcester MA 01655-0002. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Fan, Pang-Yen can be contacted via phone (508) 856-3155.

Contact Information

Primary practice address
55 Lake Ave N Worcester MA 01655-0002
Phone: (508) 856-3155
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 59692 Massachusetts

Profile Details

NPI number 1477536936
LBN Legal business name Fan, Pang-Yen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 29th, 2005
Last updated Nov 5th, 2020 - about 5 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 1477536936 NPPES
Massachusetts MEDICAID 3042588

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