Provider Demographics
NPI:1447404512
Name:CHAN, JAMES ONG (PHYSICAL THERAPY)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ONG
Last Name:CHAN
Suffix:
Gender:M
Credentials:PHYSICAL THERAPY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9441 ALSTYNE AVE
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-2828
Mailing Address - Country:US
Mailing Address - Phone:917-684-1736
Mailing Address - Fax:
Practice Address - Street 1:9441 ALSTYNE AVE
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-2828
Practice Address - Country:US
Practice Address - Phone:917-684-1736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-15
Last Update Date:2008-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028153225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist