Individual ProviderKevin G ChanPharmacistPharmacy Service ProvidersPractice Address168 Montague St, Brooklyn, NY 11201-3615(718) 522-2991PECOS EnrollmentBased on the most recent information from CMS, provider Kevin G Chan does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1548441397Provider TypeIndividualFull NameChan, Kevin GTitleMr.CredentialRPHGenderMaleSole ProprietorYesEnumeration Date11/21/2007Last Updated11/21/2007Contact InformationPractice LocationPractice Address168 Montague St, Brooklyn, NY 11201-3615Phone(718) 522-2991FaxUnlisted FaxMailing LocationMailing Address168 Montague St, Brooklyn, NY 11201-3615Phone(718) 522-2991FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode183500000XPrimaryDescriptionPharmacistPharmacy Service ProvidersLicense044436New YorkProvider IdentifiersIDDescriptionIssuerID01562427DescriptionMedicaidIssuerUnlistedNew York