Basic Information
Provider Information
NPI: 1407879026
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHAN
FirstName: CINDY
MiddleName: HOYING
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 711 TROY SCHENECTADY RD STE 203
Address2:  
City: LATHAM
State: NY
PostalCode: 121102461
CountryCode: US
TelephoneNumber: 5187823700
FaxNumber: 5187823799
Practice Location
Address1: 1201 NOTT ST
Address2: SUITE 102
City: SCHENECTADY
State: NY
PostalCode: 123082589
CountryCode: US
TelephoneNumber: 5183827500
FaxNumber: 5183827572
Other Information
ProviderEnumerationDate: 07/25/2006
LastUpdateDate: 01/19/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X213288NYY Allopathic & Osteopathic PhysiciansInternal Medicine 

ID Information
IDTypeStateIssuerDescription
11025001NYMVPOTHER
40S43101NYEMPIRE BCOTHER
764502801NYAETNAOTHER
20001901NYSENIOR WHOLE HEALTHOTHER
07012400005901NYFIDELISOTHER
1006249101NYCDPHPOTHER
5769901NYGHI/HMOOTHER
00049988100101NYBSNENYOTHER
0225681105NY MEDICAID


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