Provider Demographics
NPI:1518751965
Name:CHAN, ALLEN (RN-BSN)
Entity type:Individual
Prefix:MR
First Name:ALLEN
Middle Name:
Last Name:CHAN
Suffix:
Gender:
Credentials:RN-BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 CALIFORNIA ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02458-1009
Mailing Address - Country:US
Mailing Address - Phone:617-319-4824
Mailing Address - Fax:617-319-4824
Practice Address - Street 1:1050 COMMONWEALTH AVE STE 300
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-1136
Practice Address - Country:US
Practice Address - Phone:617-264-7100
Practice Address - Fax:617-264-7100
Is Sole Proprietor?:No
Enumeration Date:2025-04-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2302961163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health