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NPI Code Detail

MEDICARE: ANDREW CHAN MD

MEDICARE:   ANDREW  CHAN  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208800000XUrology Physician0101289668VA
2208800000XUrology Physician212819NY

General Provider Information

NPI Number : 1356304273
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW CHAN MD
Provider Business Mailing Address
First Line : 480 HICKSVILLE RD
Second Line :
City : BETHPAGE
State : NY
Zip : 11714-3415
Country : US
Telephone Number : 516-796-2222
Fax Number : 516-796-2303
Provider Business Practice Location Address
First Line : 4230 HEMPSTEAD TPKE
Second Line :
City : BETHPAGE
State : NY
Zip : 11714-5700
Country : US
Telephone Number : 516-796-2222
Fax Number : 516-796-2303
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2006
Last Update Date : 06/02/2026

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