Provider Demographics
NPI:1295563146
Name:CHAN, LINDSEY BROOKE (OD)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:BROOKE
Last Name:CHAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:546 NOSTRAND AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-2013
Mailing Address - Country:US
Mailing Address - Phone:718-230-0774
Mailing Address - Fax:929-234-3172
Practice Address - Street 1:546 NOSTRAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11216-2013
Practice Address - Country:US
Practice Address - Phone:718-230-0774
Practice Address - Fax:929-234-3172
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-23
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010003152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management