Provider Demographics
NPI:1841564598
Name:CHAN, PINGKWAN ALBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:PINGKWAN
Middle Name:ALBERT
Last Name:CHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 BAYLIS LN
Mailing Address - Street 2:APT 7D
Mailing Address - City:BEDFORD
Mailing Address - State:NY
Mailing Address - Zip Code:10506-1504
Mailing Address - Country:US
Mailing Address - Phone:914-238-4213
Mailing Address - Fax:888-272-1315
Practice Address - Street 1:180 RIVERSIDE DR
Practice Address - Street 2:APT 7D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-1021
Practice Address - Country:US
Practice Address - Phone:212-315-1939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-28
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY163459174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist