Provider Demographics
NPI:1861745127
Name:CHAN, ERIC WAI HONG (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:WAI HONG
Last Name:CHAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8309 BROADWAY FL 1
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-5794
Mailing Address - Country:US
Mailing Address - Phone:929-522-0393
Mailing Address - Fax:929-522-0391
Practice Address - Street 1:8309 BROADWAY
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-5794
Practice Address - Country:US
Practice Address - Phone:929-522-0393
Practice Address - Fax:929-522-0391
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-23
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY057150183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist