Provider Demographics
NPI:1023558137
Name:CHINATOWN CARDIOVASCULAR DISEASE PC
Entity Type:Organization
Organization Name:CHINATOWN CARDIOVASCULAR DISEASE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:TAK
Authorized Official - Middle Name:W
Authorized Official - Last Name:KWAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-886-3723
Mailing Address - Street 1:4235 MAIN ST
Mailing Address - Street 2:3M
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-3956
Mailing Address - Country:US
Mailing Address - Phone:718-886-3723
Mailing Address - Fax:646-365-0469
Practice Address - Street 1:4235 MAIN ST
Practice Address - Street 2:3M
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3956
Practice Address - Country:US
Practice Address - Phone:718-886-3723
Practice Address - Fax:646-365-0469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-08
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty