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General NPI Number Information
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NPI Number | 1396712105
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Entity Type | Individual
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Provider Name | IRIS TANCHI CHAN MD PHD
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Gender | Female
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Dates
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Enumeration Date | 03/01/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 44 BINNEY STREET SUITE D1 B30
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City | BOSTON
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State | MA
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Zip | 02115
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Country | US
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Telephone | 617-632-6922
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Fax | 617-355-9092
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Provider Business Mailing Address
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Address Line | 400 BROOKLINE AVENUE APT 21 G
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City | BOSTON
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State | MA
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Zip | 02215
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Country | US
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Telephone | 617-278-6064
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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 | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | 210272
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License Number State | MA
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