Provider Demographics
NPI:1225053523
Name:CHAN, SING (MD)
Entity Type:Individual
Prefix:
First Name:SING
Middle Name:
Last Name:CHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3808 UNION ST
Mailing Address - Street 2:STE 3N
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-5670
Mailing Address - Country:US
Mailing Address - Phone:718-886-6292
Mailing Address - Fax:646-224-8549
Practice Address - Street 1:3808 UNION ST
Practice Address - Street 2:STE 3N
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5670
Practice Address - Country:US
Practice Address - Phone:516-238-6855
Practice Address - Fax:646-224-8549
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY192380207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01877912Medicaid
NY01877912Medicaid
NY03119Medicare ID - Type Unspecified