| Shih-han Chan Medical Pc | |
|
1 Hewitt Sq Suite 146 East Northport NY 11731-2519 | |
| (631) 271-9151 | |
| (631) 271-9155 |
| Full Name | Shih-han Chan Medical Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1 Hewitt Sq, East Northport, New York |
| Authorized Official Name and Position | Bonnie Omedes (OFFICE MANAGER) |
| Authorized Official Contact | 6312719151 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shih-han Chan Medical Pc 1 Hewitt Sq Suite 146 East Northport NY 11731-2519 Ph: (631) 271-9151 | Shih-han Chan Medical Pc 1 Hewitt Sq Suite 146 East Northport NY 11731-2519 Ph: (631) 271-9151 |
| NPI Number | 1124364005 |
|---|---|
| Provider Enumeration Date | 12/20/2012 |
| Last Update Date | 03/04/2013 |
| Medicare PECOS PAC ID | 5092951368 |
|---|---|
| Medicare Enrollment ID | O20130412000100 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124364005 | NPI | - | NPPES |
| 253140-1 | Other | NY | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | 253140-1 (New York) | Primary |
| Provider Name | Shih-han Chan |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1851588826 PECOS PAC ID: 5890832869 Enrollment ID: I20091023000093 |
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