MEDICARE: JOSEPHINE I CHEN NP

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	363LF0000X	Family Nurse Practitioner	348035	NY

General Provider Information

NPI Number	:	1659016418
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPHINE I CHEN NP

Provider Business Mailing Address
First Line	:	4916 87TH ST
Second Line	:
City	:	ELMHURST
State	:	NY
Zip	:	11373-3949
Country	:	US
Telephone Number	:	973-216-1158
Fax Number	:

Provider Business Practice Location Address
First Line	:	4916 87TH ST
Second Line	:
City	:	ELMHURST
State	:	NY
Zip	:	11373-3949
Country	:	US
Telephone Number	:	973-216-1158
Fax Number	:

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

Provider Enumeration Date	:	05/04/2022
Last Update Date	:	05/04/2022

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