Active NPI
Man Shan Chan, PHARM.D.
- Pharmacist
- Brooklyn, NY
National Provider Identifier
1831434364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 057451
- Practice address
- 6413 18TH Ave
Brooklyn, NY 11204-3730 - Phone
- (718) 256-1020
- NPI assigned
- Dec 10, 2012
- Last updated
- Jun 11, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 057451 | NY | Primary |
Addresses
Primary practice location
6413 18TH Ave
Brooklyn, NY 11204-3730
Mailing address
57 Ruth PL
Staten Island, NY 10305-2430
Phone (201) 687-9849
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 057451 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Pharmacy Inc | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1355097600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623369600000",
"number": "1831434364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "57 RUTH PL",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103052430",
"telephone_number": "201-687-9849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6413 18TH AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112043730",
"telephone_number": "718-256-1020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAN",
"first_name": "MAN SHAN",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-12-10",
"last_updated": "2021-06-11",
"certification_date": "2021-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "057451",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.