Provider Demographics
NPI:1902116296
Name:CHAN, RAVY (RPA-C)
Entity type:Individual
Prefix:MISS
First Name:RAVY
Middle Name:
Last Name:CHAN
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3276 WESTCHESTER AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-4510
Mailing Address - Country:US
Mailing Address - Phone:929-436-1200
Mailing Address - Fax:347-657-0565
Practice Address - Street 1:3276 WESTCHESTER AVE FL 2
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-4510
Practice Address - Country:US
Practice Address - Phone:929-436-1200
Practice Address - Fax:347-657-0565
Is Sole Proprietor?:No
Enumeration Date:2010-10-20
Last Update Date:2024-10-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY014199363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant