Provider Demographics
NPI:1811960446
Name:CHAN, YEOMAN KIN-LUNG (MD)
Entity type:Individual
Prefix:DR
First Name:YEOMAN
Middle Name:KIN-LUNG
Last Name:CHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 BRUNSWICK ST FL 1
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-6017
Mailing Address - Country:US
Mailing Address - Phone:718-983-0660
Mailing Address - Fax:718-983-7523
Practice Address - Street 1:41 BRUNSWICK ST FL 1
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-6017
Practice Address - Country:US
Practice Address - Phone:718-983-0660
Practice Address - Fax:718-983-7523
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2019-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225089207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3332277OtherAETNA HMO/QPOS
NY92938OtherGHI HMO
NY010160203OtherAMERICHOICE
NY02312292Medicaid
NY7695439OtherAETNA PPO
NY0899990OtherGHI PPO
NY150870201OtherHEALTHPLUS
NY170955OtherELDERPLAN
NY22135590OtherFIRST HEALTH
NY2292542OtherUNITED HEALTH CARE
NY5569B1OtherBLUE CROSS BLUE SHIELD
NYP2789054OtherOXFORD
NY0104069OtherUHC MEDICARE/MEDICAID
NY0104389006OtherCIGNA
NYH85954Medicare UPIN
NY92938OtherGHI HMO