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General NPI Number Information
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NPI Number | 1386535177
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Entity Type | Individual
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Provider Name | ANNIE CHAN OD
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Gender | Female
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Dates
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Enumeration Date | 07/10/2025
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Last Update Date | 09/07/2025
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Provider Practice Location Address
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Address Line | 33 W 42ND ST
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City | NEW YORK
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State | NY
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Zip | 10036-8005
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Country | US
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Telephone | 917-318-2985
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Fax |
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Provider Business Mailing Address
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Address Line | 4720 CENTER BLVD APT 2102
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City | LONG ISLAND CITY
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State | NY
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Zip | 11109-5654
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Country | US
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Telephone | 917-318-2985
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 011254
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License Number State | NY
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