Siu Mei Chan, OTR/L

Individual provider Active NPI Occupational Therapist · Glendale, NY

NPI 1396989307 · NPPES record last updated Feb 24, 2022

Key facts

NPI
1396989307
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
005749-1 (NY)
Practice address
6820 Myrtle Ave
Glendale, NY 11385-7235
Phone
(718) 326-8170
NPI assigned
Apr 22, 2009
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
005749-1NYMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Interdisciplinary Center for Child Development, Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 005749-1 NY Yes

Addresses

Primary practice location

6820 Myrtle Ave
Glendale, NY 11385-7235

Mailing address

3555 223Rd St
Bayside, NY 11361-2236
Phone (718) 428-5370

Other providers in Glendale, NY

All providers in Glendale, NY · Occupational Therapist in New York

Sources for this page

Verify at the official NPI Registry.