Healthcare Provider Details

I. General information

NPI: 1285824821
Provider Name (Legal Business Name): BEST CHOICE MEDICAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2007
Last Update Date: 08/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1461 LAKELAND AVE UNIT 14
BOHEMIA NY
11716-2174
US

IV. Provider business mailing address

1461 LAKELAND AVE UNIT 14
BOHEMIA NY
11716-2174
US

V. Phone/Fax

Practice location:
  • Phone: 631-218-8800
  • Fax: 631-218-8801
Mailing address:
  • Phone: 631-218-8800
  • Fax: 631-218-8801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number200300
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier01837470
Identifier TypeMEDICAID
Identifier StateNY
Identifier Issuer

VIII. Authorized Official

Name: ENOCH CHAN
Title or Position: OWNER
Credential: MD
Phone: 631-218-8800