Provider Demographics
NPI:1699158352
Name:CHAN, YIK HAN (MA, RD, CDN, CDCES)
Entity type:Individual
Prefix:
First Name:YIK HAN
Middle Name:
Last Name:CHAN
Suffix:
Gender:F
Credentials:MA, RD, CDN, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6721 EXETER ST
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4149
Mailing Address - Country:US
Mailing Address - Phone:267-693-7088
Mailing Address - Fax:
Practice Address - Street 1:6721 EXETER ST
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4149
Practice Address - Country:US
Practice Address - Phone:267-693-7088
Practice Address - Fax:215-748-9237
Is Sole Proprietor?:No
Enumeration Date:2015-06-30
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1057883133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered