Provider Demographics
NPI:1649554130
Name:CHAN, CINDY (PHARM D)
Entity type:Individual
Prefix:DR
First Name:CINDY
Middle Name:
Last Name:CHAN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PAWLING
Mailing Address - State:NY
Mailing Address - Zip Code:12564-1405
Mailing Address - Country:US
Mailing Address - Phone:845-855-5100
Mailing Address - Fax:
Practice Address - Street 1:26 E MAIN ST
Practice Address - Street 2:
Practice Address - City:PAWLING
Practice Address - State:NY
Practice Address - Zip Code:12564-1405
Practice Address - Country:US
Practice Address - Phone:845-855-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-03
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYI049753-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist