MEDICARE: DR. CHRISTOPHER CHAN O.D.

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	152W00000X	Optometrist	008489	NY

General Provider Information

NPI Number	:	1821440322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER CHAN O.D.

Provider Business Mailing Address
First Line	:	13512 ROOSEVELT AVE
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11354-5342
Country	:	US
Telephone Number	:	718-886-8637
Fax Number	:

Provider Business Practice Location Address
First Line	:	21411 73RD AVE
Second Line	:
City	:	OAKLAND GARDENS
State	:	NY
Zip	:	11364-2947
Country	:	US
Telephone Number	:	718-225-5533
Fax Number	:

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

Provider Enumeration Date	:	07/07/2016
Last Update Date	:	07/01/2025

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