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General NPI Number Information
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NPI Number | 1093513467
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Entity Type | Organization
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Legal Business Name | JIMMY CHAN MD PLLC
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Dates
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Enumeration Date | 03/03/2025
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Last Update Date | 03/03/2025
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Provider Practice Location Address
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Address Line | 130 E 77TH ST FL HALL7
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City | NEW YORK
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State | NY
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Zip | 10075-1851
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Country | US
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Telephone | 914-471-0667
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Fax |
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Provider Business Mailing Address
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Address Line | 656 CENTRAL PARK AVE # 168
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City | SCARSDALE
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State | NY
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Zip | 10583-2512
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | JIMMY CHAN
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Credential | MD
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Telephone | 914-471-0667
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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