Provider Demographics
NPI:1346373404
Name:EMILY LINDA CHAN, MD, PC
Entity Type:Organization
Organization Name:EMILY LINDA CHAN, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:LINDA
Authorized Official - Last Name:CHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-226-6468
Mailing Address - Street 1:53 ELIZABETH ST
Mailing Address - Street 2:SUITE 4B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4617
Mailing Address - Country:US
Mailing Address - Phone:212-226-6468
Mailing Address - Fax:212-226-6469
Practice Address - Street 1:53 ELIZABETH ST
Practice Address - Street 2:SUITE 4B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4617
Practice Address - Country:US
Practice Address - Phone:212-226-6468
Practice Address - Fax:212-226-6469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY242079174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty