Provider Demographics
NPI:1760741847
Name:CHAN, SAU SHEUNG (SERVICE COORDINATOR)
Entity Type:Individual
Prefix:MS
First Name:SAU SHEUNG
Middle Name:
Last Name:CHAN
Suffix:
Gender:F
Credentials:SERVICE COORDINATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3144 81ST ST
Mailing Address - Street 2:
Mailing Address - City:EAST ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11370-1911
Mailing Address - Country:US
Mailing Address - Phone:646-509-6680
Mailing Address - Fax:
Practice Address - Street 1:9409 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:WOODHAVEN
Practice Address - State:NY
Practice Address - Zip Code:11421-2222
Practice Address - Country:US
Practice Address - Phone:718-846-9821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-10
Last Update Date:2012-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator