DR. KENNETH KWOK-CHUN CHAN (NPI# 1639178460) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639178460 |
| Entity Type | Individual |
| Full Name | DR. KENNETH KWOK-CHUN CHAN |
| Credential | M.D. |
| Practice Address |
140 Haverhill St Andover MA 01810-1504 |
| Practice Telephone | 9784754522 |
| Practice Fax Number | 9784756531 |
| Mailing Telephone | 9784754522 |
| Mailing Fax Number | 9784756531 |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 205542 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 0124010 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811079106 | Kenneth Ka Chan | Dentist | 1315 Fair Oaks Ave Ste 103, South Pasadena, CA 91030-3868 | 2006-10-19 |
| 1912091919 | Kenneth Dong Chan | Internal Medicine | 789 Vallejo St, San Francisco, CA 94133-3834 | 2006-10-03 |
| 1124446117 | Kenneth Kin Kan Chan | Family Medicine | 2160 S. First Avenue, Loyola Outpatient Center, 4300, Maywood, IL 60153 | 2014-04-07 |
| 1033421177 | Kenneth Chan | Occupational Therapist | 18 Heyward St, Brooklyn, NY 11211-9210 | 2010-07-06 |
| 1336306083 | Kenneth Kian-lip Chan | Physician Assistant | 11 Bishop Place, Occupational Health Dept B3, New Brunswick, NJ 08901 | 2008-05-20 |
| 1780762435 | Kenneth K.m. Chan | Internal Medicine | 1600 Eureka Rd, Roseville, CA 95661-3027 | 2006-11-01 |
| 1861422370 | Kenneth Mankin Chan | Internal Medicine | 207 S Santa Anita Ave, San Gabriel, CA 91776-1146 | 2006-07-03 |
| 1649236480 | Kenneth Kai Hei Chan | Specialist | 23441 Madison St, #290, Torrance, CA 90505-4725 | 2006-04-21 |
| 1720042138 | Kenneth Chan | Psychiatry & Neurology | 4802 E Johnson Ave, Jonesboro, AR 72401-8413 | 2006-04-13 |
| Street Address |
140 HAVERHILL ST |
| City | ANDOVER |
| State | MA |
| Zip Code | 01810-1504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710985882 | Robert Peter Nelken | Pediatrics | 140 Haverhill St, Andover, MA 01810-1504 | 2005-07-12 |
| 1073022646 | Laura J Gordon | Psychologist | 140 Haverhill St, Andover, MA 01810-1550 | 2017-09-26 |
| 1952703092 | Katie Lynn Wallace | Nurse Practitioner | 140 Haverhill St, Andover, MA 01810-1550 | 2014-09-19 |
| 1104116086 | Andover Surgical Associates, LLC | Surgery | 140 Haverhill St, Andover, MA 01810-1550 | 2011-04-13 |
| 1407160435 | Katerina Angelica Mooers | Nurse Practitioner | 140 Haverhill St, Bldg 1, Andover, MA 01810-1550 | 2010-08-02 |
| 1245467794 | Jennifer C Hensley | Pediatrics | 140 Haverhill St, Andover, MA 01810-1550 | 2009-06-11 |
| 1760653679 | Winchester Physician Associates | Emergency Medicine | 140 Haverhill St, Andover, MA 01810-1550 | 2008-03-19 |
| 1700069820 | Sarah Bethany Finch | Obstetrics & Gynecology | 140 Haverhill St, Andover, MA 01810 | 2007-12-12 |
| 1215134390 | Earl R Gonzales | Surgery | 140 Haverhill St, Andover, MA 01810-1550 | 2007-07-02 |
| 1659498517 | Andover Urology Associates | Specialist | 140 Haverhill St, Doctors Park 1, Andover, MA 01810-1550 | 2007-03-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871123513 | Jill Katherine Priestley | Registered Nurse | 251 South Main Street, Andover, MA 01810 | 2020-01-22 |
| 1023672086 | Diane Marie Gallant | Occupational Therapy Assistant | 5606 80 Andover Street, Andover, MA 01810 | 2019-04-25 |
| 1932677473 | Jessica Howie | Physician Assistant | 28 Andover St Fl 1, Andover, MA 01810 | 2018-11-02 |
| 1972087138 | Mia Cloonan | Social Worker | 1 Punchard Avenue, Apt. 3 Rear, Andover, MA 01810 | 2018-09-23 |
| 1063995462 | Janet Suleski | Social Worker | 10 Stevens St, Andover, MA 01810 | 2018-09-11 |
| 1942794706 | Alison Catherine Lynch | Optometrist | 7 Parthenon Cir, Andover, MA 01810 | 2018-06-15 |
| 1740773647 | Wandajune Bishop-towle | Psychologist | 75 Wild Rose Dr., Andover, MA 01810 | 2018-06-14 |
| 1235689860 | Jo-ann Elizabeth Newcomb | Registered Nurse | 12 Hemlock Rd, Andover, MA 01810 | 2016-10-06 |
| 1922476712 | Marianela Rivera | Physical Therapist | 32 Osgood St., Andover, MA 01810 | 2015-09-10 |
| 1447535935 | Kathleen L Mccracken | Occupational Therapy Assistant | 200 Brickstone Square, 3rd Floor, Genesis Rehab Services, Andover, MA 01810 | 2011-10-15 |
| Find all providers in zip 01810 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962464768 | Richard Dean Miller | Pediatrics | 943 N Andover Rd, Suite G, Andover, KS 67002-9795 | 2006-04-05 |
| 1710985882 | Robert Peter Nelken | Pediatrics | 140 Haverhill St, Andover, MA 01810-1504 | 2005-07-12 |
| 1245467794 | Jennifer C Hensley | Pediatrics | 140 Haverhill St, Andover, MA 01810-1550 | 2009-06-11 |
| 1801088778 | Brittany N Johnston | Pediatrics | 15245 Bluebird St Nw, Riverway Clinic-andover, Andover, MN 55304-3554 | 2007-08-15 |
| 1316069149 | Joseph W. Desiato, M.d. PC | Pediatrics | 349 N Main St, Andover, MA 01810-2687 | 2007-04-04 |
| 1548393176 | Andover Pediatrics, P.C. | Pediatrics | 140 Haverhill St, Andover, MA 01810-1550 | 2007-03-13 |
| 1891822243 | Rebecca Ann Konieczny | Pediatrics | 323 Lowell St, Andover, MA 01810 | 2007-02-27 |
| 1356435366 | Joseph William Desiato | Pediatrics | 349 N Main St, Andover, MA 01810-2687 | 2006-10-03 |
| 1639289713 | Michael Andrew Fischer | Pediatrics | 323 Lowell St, Andover Medical Center & Express Care, Andover, MA 01810 | 2006-08-30 |
| 1871502203 | Rhodessa Fidela Kabatay Burt | Pediatrics | 13819 Hanson Blvd Nw, Andover, MN 55304-7608 | 2006-08-05 |
| Find all providers in ANDOVER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.