MEDICARE: DR. PASCUAL CHEN PSY.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	103T00000X	Psychologist	019144	NY
2	103T00000X	Psychologist	PS017209	PA

General Provider Information

NPI Number	:	1588828875
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PASCUAL CHEN PSY.D.

Provider Business Mailing Address
First Line	:	6200 BROOKTREE RD STE 110
Second Line	:
City	:	WEXFORD
State	:	PA
Zip	:	15090-9299
Country	:	US
Telephone Number	:	412-628-2818
Fax Number	:

Provider Business Practice Location Address
First Line	:	6200 BROOKTREE RD STE 110
Second Line	:
City	:	WEXFORD
State	:	PA
Zip	:	15090-9299
Country	:	US
Telephone Number	:	412-628-2818
Fax Number	:

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

Provider Enumeration Date	:	07/15/2008
Last Update Date	:	01/01/2021

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