Provider Demographics
NPI:1144410671
Name:CHIN, HERBERT (RPA)
Entity Type:Individual
Prefix:MR
First Name:HERBERT
Middle Name:
Last Name:CHIN
Suffix:
Gender:M
Credentials:RPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 01 30 AVENUE
Mailing Address - Street 2:#400
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103
Mailing Address - Country:US
Mailing Address - Phone:718-726-7000
Mailing Address - Fax:718-335-1791
Practice Address - Street 1:35 01 30 AVE
Practice Address - Street 2:#400
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11103
Practice Address - Country:US
Practice Address - Phone:718-726-7000
Practice Address - Fax:718-335-1791
Is Sole Proprietor?:No
Enumeration Date:2007-07-31
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000173-1363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical