Provider Demographics
NPI:1073842233
Name:PARD H. CHAN OD,PC
Entity Type:Organization
Organization Name:PARD H. CHAN OD,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PARD
Authorized Official - Middle Name:H
Authorized Official - Last Name:CHAN
Authorized Official - Suffix:
Authorized Official - Credentials:O D
Authorized Official - Phone:845-352-9797
Mailing Address - Street 1:2 NOTTINGHAM CT
Mailing Address - Street 2:
Mailing Address - City:NANUET
Mailing Address - State:NY
Mailing Address - Zip Code:10954-3846
Mailing Address - Country:US
Mailing Address - Phone:845-352-9797
Mailing Address - Fax:845-352-3991
Practice Address - Street 1:50 OVERLOOK BLVD
Practice Address - Street 2:
Practice Address - City:NANUET
Practice Address - State:NY
Practice Address - Zip Code:10954-5290
Practice Address - Country:US
Practice Address - Phone:845-426-2044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-17
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV004766152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty