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General NPI Number Information
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NPI Number | 1396989307
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Entity Type | Individual
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Provider Name | SIU MEI CHAN OTR/L
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Gender | Female
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Dates
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Enumeration Date | 04/22/2009
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Last Update Date | 02/24/2022
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Provider Practice Location Address
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Address Line | 6820 MYRTLE AVE
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City | GLENDALE
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State | NY
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Zip | 11385-7235
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Country | US
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Telephone | 718-326-8170
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Fax |
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Provider Business Mailing Address
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Address Line | 3555 223RD ST
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City | BAYSIDE
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State | NY
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Zip | 11361-2236
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Country | US
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Telephone | 718-428-5370
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Fax | 718-428-5462
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 005749-1
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License Number State | NY
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