Healthcare Provider Details

I. General information

NPI: 1912195678
Provider Name (Legal Business Name): PAULINE CHEN HALSEY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PAULINE W. CHEN M.D.

II. Dates (important events)

Enumeration Date: 10/09/2007
Last Update Date: 05/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 VFW PKWY
WEST ROXBURY MA
02132
US

IV. Provider business mailing address

91 GREEN ST
JAMAICA PLAIN MA
02130-2201
US

V. Phone/Fax

Practice location:
  • Phone: 978-373-6419
  • Fax:
Mailing address:
  • Phone: 978-943-9516
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberGFE84623
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License NumberGFE84623
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberGFE84623
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License NumberGFE84623
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: