Provider Demographics
NPI:1619047313
Name:CHAN, SING KIT KEITH (MPT)
Entity Type:Individual
Prefix:MR
First Name:SING KIT
Middle Name:KEITH
Last Name:CHAN
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 GREENWICH ST
Mailing Address - Street 2:APT 329
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10006-2204
Mailing Address - Country:US
Mailing Address - Phone:917-304-9203
Mailing Address - Fax:
Practice Address - Street 1:214 E 70TH ST
Practice Address - Street 2:GF
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-5425
Practice Address - Country:US
Practice Address - Phone:917-304-9203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028726225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY028726OtherPT LICENCE NUMBER