Katherine Chan, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

035005 Issued in NY

Practice address

3391 Richmond Ave
Staten Island, NY 10312-2025

Phone

(718) 608-9170

NPI assigned

Nov 13, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1731456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1043034283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3213 210TH ST",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113611063",
            "telephone_number": "347-308-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3391 RICHMOND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103122025",
            "telephone_number": "718-608-9170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "KATHERINE",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-13",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "035005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Rose Chan
• Gloria Chan, CRNA
• Juhyun Lisa Chan, P.A.
• Justin Chan
• Kamse Suk Chan, LCSW
• Kristina Chan
• Kwun Y Chan, RN
• Peggy Chan, M.D.
• Samuel Chan
• Siu-Pun Chan, MD

• Speech-Language Pathologist in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.