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General NPI Number Information
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NPI Number | 1609946599
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Entity Type | Individual
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Provider Name | EMILY LINDA CHAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 128 MOTT ST SUITE 301
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City | NEW YORK
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State | NY
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Zip | 10013-5540
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Country | US
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Telephone | 212-274-1578
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Fax | 212-274-1584
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Provider Business Mailing Address
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Address Line | 102 MAJOR RD
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City | MONMOUTH JCT
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State | NJ
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Zip | 08852-2334
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Country | US
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Telephone | 732-274-1602
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Fax | 732-274-1602
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 242079
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License Number State | NY
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