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General NPI Number Information
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NPI Number | 1033431069
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Entity Type | Individual
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Provider Name | BANSON C C CHAN RPH
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Gender | Male
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Dates
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Enumeration Date | 02/17/2010
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Last Update Date | 02/17/2010
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Provider Practice Location Address
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Address Line | 227 MADISON ST
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City | NEW YORK
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State | NY
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Zip | 10002-7537
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Country | US
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Telephone | 212-238-7103
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Fax | 212-238-7065
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Provider Business Mailing Address
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Address Line | 227 MADISON ST
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City | NEW YORK
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State | NY
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Zip | 10002-7537
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Country | US
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Telephone | 212-238-7103
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Fax | 212-238-7065
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 035751
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 28R101775400
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License Number State | NJ
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