Chan, Wayne Ken
Chan, Wayne Ken is an sole proprietor health care provider with primary practice located at 229 Berkeley St , Boston MA 02116-3724. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Chan, Wayne Ken can be contacted via phone (617) 247-0012.Contact Information
Primary practice address
229 Berkeley St
Boston MA 02116-3724
Phone: (617) 247-0012
Fax: (508) 872-7091
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 3419 | Massachusetts |
Profile Details
| NPI number | 1255323473 |
|---|---|
| LBN Legal business name | Chan, Wayne Ken |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 16th, 2005 |
| Last updated | Jan 22nd, 2010 - about 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1255323473 | NPPES |
| Massachusetts | MEDICAID | 0354333 |
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