Evangelina Chan, MSW,LCSW

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

081696-1 Issued in NY

Practice address

46 Albion St
Bridgeport, CT 06605-2602

Phone

(203) 330-6000

Fax

(203) 330-6008

NPI assigned

Dec 19, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Evangelina NG Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Henry Street Settlement

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New York, NY
  • NPI 1629172036
  NPD

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

{
    "created_epoch": "1355875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521072000000",
    "number": "1245576248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 W 125TH ST",
            "address_2": "FL 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100274575",
            "telephone_number": "212-942-5615",
            "fax_number": "212-682-2613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 ALBION ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066052602",
            "telephone_number": "203-330-6000",
            "fax_number": "203-330-6008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "EVANGELINA",
        "credential": "MSW,LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-19",
        "last_updated": "2018-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "081696-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "008301",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004236148",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EVANGELINA",
            "last_name": "NG",
            "credential": "MSW,LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Shashi Chaddha, MD
• Spyridon Chalkias, MD
• Donna Chambers-Smith
• Annika Nicole Chambers, MD
• Charalene Chambers
• Venu Channamsetty, MD
• Sally Syaunan Chao, M.D.
• Nibedita Chapagain, MD
• Yves Marie Charles
• Megan Charleston

• Child & Adolescent Psychiatry Physician in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Child & Adolescent Psychiatry Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.