Basic Information
| Provider Information | |||||||||
| NPI: | 1740522762 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | CHIN | ||||||||
| FirstName: | ERIC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 35 S BROADWAY APT N5 | ||||||||
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| City: | IRVINGTON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105331820 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9144822628 | ||||||||
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| Practice Location | |||||||||
| Address1: | 450 BROOKLINEAVE | ||||||||
| Address2: | DANA-FARBER CANCER INSTITUTE | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177325500 | ||||||||
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| ProviderEnumerationDate: | 03/18/2013 | ||||||||
| LastUpdateDate: | 04/07/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.