Healthcare Provider Details

I. General information

NPI: 1699290965
Provider Name (Legal Business Name): YUEN KWAN CHAN OB/GYN NP, MIDWIFE P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2017
Last Update Date: 01/25/2023
Certification Date: 01/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1672 81ST ST FL 3
BROOKLYN NY
11214-2108
US

IV. Provider business mailing address

2962 BRIGHTON 5TH ST
BROOKLYN NY
11235-8514
US

V. Phone/Fax

Practice location:
  • Phone: 347-941-0186
  • Fax:
Mailing address:
  • Phone: 917-915-5055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberF001357
License Number StateNY

VIII. Authorized Official

Name: YUEN KWAN CHAN
Title or Position: CNM/ DIRECTOR
Credential: CNM, OB/GYN NP, DNP
Phone: 347-941-0186