Provider Demographics
NPI:1164061602
Name:WING HONG CHAN PHYSIOTHERAPY, P.C.
Entity Type:Organization
Organization Name:WING HONG CHAN PHYSIOTHERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WING HONG
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-908-0207
Mailing Address - Street 1:3901 MAIN ST STE 509
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-5433
Mailing Address - Country:US
Mailing Address - Phone:917-908-0207
Mailing Address - Fax:917-908-0205
Practice Address - Street 1:3901 MAIN ST STE 509
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5433
Practice Address - Country:US
Practice Address - Phone:917-908-0207
Practice Address - Fax:917-908-0205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-01
Last Update Date:2020-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty