Provider Demographics
NPI:1942638135
Name:CHAN, CHRISTINE (MS)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:CHAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 MONROE ST
Mailing Address - Street 2:FI7
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-7793
Mailing Address - Country:US
Mailing Address - Phone:646-255-8286
Mailing Address - Fax:
Practice Address - Street 1:40 MONROE ST
Practice Address - Street 2:FI7
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-7793
Practice Address - Country:US
Practice Address - Phone:646-255-8286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-24
Last Update Date:2016-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist