MEDICARE: MAN SHAN CHAN PHARM.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	183500000X	Pharmacist	057451	NY

General Provider Information

NPI Number	:	1831434364
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAN SHAN CHAN PHARM.D.

Provider Business Mailing Address
First Line	:	57 RUTH PL
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10305-2430
Country	:	US
Telephone Number	:	201-687-9849
Fax Number	:

Provider Business Practice Location Address
First Line	:	6413 18TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204-3730
Country	:	US
Telephone Number	:	718-256-1020
Fax Number	:

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

Provider Enumeration Date	:	12/10/2012
Last Update Date	:	06/11/2021

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Directions to “ MAN SHAN CHAN PHARM.D.” Practice Location

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