Individual provider · Type 1 NPI

Juhyun Lisa Chan, P.A.

Medical Physician Assistant · Staten Island, NY

NPI number 1205194057 Active

Practice location

475 Seaview Ave
Staten Island, NY 10305-3436

Call (718) 226-9158 Map

Fax (718) 226-6964

Mailing address

4 Airdale Dr
Kendall Park, NJ 08824-1494

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant 363AM0700X25MP00050600 (NJ)
Medical Physician Assistant Primary 363AM0700X006335 (NY)

Medical Physician Assistant: Definition to come...

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About NPI 1205194057

Juhyun Lisa Chan, P.A.'s National Provider Identifier is 1205194057, issued on Apr 30, 2012. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Staten Island, NY. The record was last updated on Jan 25, 2013.