Chan, Grace J

Chan, Grace J is an individual health care provider with primary practice located at 300 Longwood Ave , Boston MA 02115. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Chan, Grace J can be contacted via phone (617) 432-3422.

Contact Information

Primary practice address
300 Longwood Ave Boston MA 02115
Phone: (617) 432-3422
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MA232804 Massachusetts

Profile Details

NPI number 1891953535
LBN Legal business name Chan, Grace J
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 29th, 2008
Last updated Dec 10th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891953535 NPPES
Maryland MEDICAID 035934300

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