Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Angie Chan

Individual provider Physician Assistant · NPI 1104571801

Angie Chan is a Physician Assistant in Stony Brook, New York. Practices as a sole proprietor. Registered with an NPI since 2022.

In the registry since
2022

Practice location Address checks out

2500 Nesconset Hwy Bldg 20B
Stony Brook, NY 11790-2563
Phone: (631) 864-6647
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1104571801
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedFebruary 21, 2022
Last updated in NPPESFebruary 10, 2023
Certification dateFebruary 10, 2023
Mailing address2500 Nesconset Hwy Bldg 20b, Stony Brook, NY 11790-2563

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