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General NPI Number Information
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NPI Number | 1326224668
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Entity Type | Individual
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Provider Name | SHIRLEY CHAN PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/17/2008
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Last Update Date | 04/09/2013
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Provider Practice Location Address
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Address Line | 1094 WORCESTER RD
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City | FRAMINGHAM
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State | MA
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Zip | 01702-5255
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Country | US
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Telephone | 508-879-2550
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Fax | 508-820-9844
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Provider Business Mailing Address
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Address Line | 321 WALNUT ST # 221
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City | NEWTON
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State | MA
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Zip | 02460-1927
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Country | US
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Telephone | 617-359-8887
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Fax |
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA2049
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License Number State | MA
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