Healthcare Provider Details

I. General information

NPI: 1912815804
Provider Name (Legal Business Name): DANNY CHAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4080 HEMPSTEAD TPKE
BETHPAGE NY
11714-5604
US

IV. Provider business mailing address

1608 UNION ST APT B
ALAMEDA CA
94501-2649
US

V. Phone/Fax

Practice location:
  • Phone: 516-862-3358
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number056324
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: