Healthcare Provider Details

I. General information

NPI: 1326817610
Provider Name (Legal Business Name): CHRISTINE CHEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2023
Last Update Date: 12/13/2025
Certification Date: 12/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 PARK ST STE 302
MONTCLAIR NJ
07042-5907
US

IV. Provider business mailing address

149 RIVERVIEW AVE
NORTH ARLINGTON NJ
07031-5944
US

V. Phone/Fax

Practice location:
  • Phone: 201-342-2550
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ14976500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: