Provider Demographics
NPI:1326449992
Name:CHAN, CHI Y (DVM)
Entity Type:Individual
Prefix:DR
First Name:CHI
Middle Name:Y
Last Name:CHAN
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02879-2228
Mailing Address - Country:US
Mailing Address - Phone:401-783-9328
Mailing Address - Fax:
Practice Address - Street 1:129 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:RI
Practice Address - Zip Code:02879-2228
Practice Address - Country:US
Practice Address - Phone:401-783-9328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-15
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDVM00615174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian