Jim Chan
Pharmacist in Rego Park, NY. Individual provider (NPI-1).
NPI number1669965331
StatusActive
Last updated in NPPESMay 27, 2021
Details
- NPI
- 1669965331
- Entity type
- Individual (NPI-1)
- Name
- Jim Chan
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 7, 2018
- Certification date
- May 27, 2021
- Last updated
- May 27, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 183500000X | Pharmacist | 064048 | NY | Yes |
Practice location
9890a Queens BlvdRego Park, NY 11374-4354
Phone 718-459-1500
Mailing address
9890a Queens BlvdRego Park, NY 11374-4354
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