Provider Demographics
NPI:1699339663
Name:CHAN, HO WING
Entity type:Individual
Prefix:
First Name:HO WING
Middle Name:
Last Name:CHAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI GME
Mailing Address - Street 2:ONE GUSTAVE L. LEVY PLACE BOX 1076
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029
Mailing Address - Country:US
Mailing Address - Phone:212-241-6694
Mailing Address - Fax:212-731-7309
Practice Address - Street 1:ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
Practice Address - Street 2:ONE GUSTAVE L. LEVY PLACE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029
Practice Address - Country:US
Practice Address - Phone:212-241-6694
Practice Address - Fax:212-731-7309
Is Sole Proprietor?:No
Enumeration Date:2019-04-25
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3208372084N0400X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program