MEDICARE: XING 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	183500000X	Pharmacist	059601	NY

General Provider Information

NPI Number	:	1598163131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	XING CHEN

Provider Business Mailing Address
First Line	:	80 DEKALB AVE APT 10G
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11201-5430
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4908 7TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-2126
Country	:	US
Telephone Number	:	917-378-2857
Fax Number	:

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

Provider Enumeration Date	:	12/14/2014
Last Update Date	:	12/14/2014

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Directions to “ XING CHEN ” Practice Location

Language	Start Address	Practice Location

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