Provider Demographics
NPI:1306482039
Name:CHAN, SYDNEY
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:
Last Name:CHAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 MERRIWEATHER DR UNIT 7050
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-4464
Mailing Address - Country:US
Mailing Address - Phone:916-802-4625
Mailing Address - Fax:
Practice Address - Street 1:2415 MUSGROVE RD STE 306
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-5205
Practice Address - Country:US
Practice Address - Phone:301-384-5977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-18
Last Update Date:2025-01-07
Deactivation Date:2024-11-27
Deactivation Code:
Reactivation Date:2024-12-17
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician