Provider Demographics
NPI:1891226924
Name:CHAN, MABEL CHING YEE (MD)
Entity Type:Individual
Prefix:
First Name:MABEL
Middle Name:CHING YEE
Last Name:CHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 W 59TH ST APT 16K
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1041
Mailing Address - Country:US
Mailing Address - Phone:213-503-0615
Mailing Address - Fax:
Practice Address - Street 1:425 W 59TH ST
Practice Address - Street 2:SUITE 7B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-8022
Practice Address - Country:US
Practice Address - Phone:212-523-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-21
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program