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General NPI Number Information
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NPI Number | 1538818091
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Entity Type | Individual
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Provider Name | ELIZABETH CHAN MD
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Gender | Female
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Dates
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Enumeration Date | 03/22/2022
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Last Update Date | 06/26/2025
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Provider Practice Location Address
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Address Line | 910 SYLVAN AVE STE 110
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City | ENGLEWOOD CLIFFS
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State | NJ
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Zip | 07632-3308
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Country | US
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Telephone | 551-501-8989
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Fax |
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Provider Business Mailing Address
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Address Line | 37595 7 MILE RD STE 210
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City | LIVONIA
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State | MI
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Zip | 48152-1003
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Country | US
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Telephone | 734-853-7690
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Fax | 734-430-9388
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MA12691900
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License Number State | NJ
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