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General NPI Number Information
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NPI Number | 1770796260
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Entity Type | Organization
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Legal Business Name | CHESTER C. LO, DPM, PC
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 198 CANAL ST SUITE 302
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City | NEW YORK
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State | NY
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Zip | 10013-4531
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Country | US
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Telephone | 212-233-9400
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Fax | 212-608-1828
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Provider Business Mailing Address
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Address Line | PO BOX 1108
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City | NEW YORK
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State | NY
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Zip | 10013-0866
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Country | US
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Telephone | 212-233-9400
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Fax | 212-608-1828
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHESTER CHINKANG LO
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Credential | DPM
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Telephone | 212-233-9400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 003582
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License Number State | NY
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