MEDICARE: MR. BEN CHEN PHARM D

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	183500000X	Pharmacist	055045	NY

General Provider Information

NPI Number	:	1215243563
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BEN CHEN PHARM D

Provider Business Mailing Address
First Line	:	1716 65TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204-3736
Country	:	US
Telephone Number	:	347-387-9021
Fax Number	:

Provider Business Practice Location Address
First Line	:	1517 CORTELYOU RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11226-5607
Country	:	US
Telephone Number	:	718-787-1665
Fax Number	:

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

Provider Enumeration Date	:	08/25/2010
Last Update Date	:	01/08/2013

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