MEDICARE: QIAN CHEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	22DI02621600	NJ

General Provider Information

NPI Number	:	1124491238
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	QIAN CHEN

Provider Business Mailing Address
First Line	:	30 REGENT ST APT 611
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07302-7352
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2000 RTE 27
Second Line	:	SUITE B
City	:	NORTH BRUNSWICK
State	:	NJ
Zip	:	08902-1348
Country	:	US
Telephone Number	:	732-398-8800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/11/2015
Last Update Date	:	11/11/2015

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Directions to “ QIAN CHEN ” Practice Location

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