MEDICARE: MS. SUSANA K CHAN PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	010893	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114004744
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SUSANA K CHAN PA

Provider Business Mailing Address
First Line	:	4860 186TH ST
Second Line	:
City	:	FRESH MEADOWS
State	:	NY
Zip	:	11365-1109
Country	:	US
Telephone Number	:	646-271-7166
Fax Number	:

Provider Business Practice Location Address
First Line	:	7206 NORTHERN BLVD
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-1049
Country	:	US
Telephone Number	:	866-670-6824
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	10/09/2025

Similar Medicare Providers

1962285726 — DIANA VANESSA QUINTERO DPT
Practice Location Address:

7206 NORTHERN BLVD FL 2
JACKSON HEIGHTS, NY
11372-1049

Practice Phone: 844-734-2201
Practice Fax: 718-533-1772

1508922527 — KEVIN I PAK MD
Practice Location Address:

7206 NORTHERN BLVD , 2ND FLOOR
JACKSON HEIGHTS, NY
11372-1049

Practice Phone: 866-670-6824
Practice Fax: 178-533-1774

1295994572 — KEVIN NAN JIANG MD
Practice Location Address:

7206 NORTHERN BLVD FL 2
JACKSON HEIGHTS, NY
11372-1049

Practice Phone: 866-670-6824
Practice Fax: 718-533-1774

1972731198 — LIBI ZAHAVA GALMER D.O.
Practice Location Address:

7206 NORTHERN BLVD
JACKSON HEIGHTS, NY
11372-1049

Practice Phone: 718-670-6824
Practice Fax:

1164651519 — DR. REZA ZARNEGAR D.O.
Practice Location Address:

7206 NORTHERN BLVD
JACKSON HEIGHTS, NY
11372-1049

Practice Phone: 718-670-1512
Practice Fax: 718-747-1262

1164789145 — LANA NIRENSTEIN MD
Practice Location Address:

7206 NORTHERN BLVD FL 2
JACKSON HEIGHTS, NY
11372-1049

Practice Phone: 866-670-6824
Practice Fax:

Directions to “ MS. SUSANA K CHAN PA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.