Healthcare Provider Details

I. General information

NPI: 1396653598
Provider Name (Legal Business Name): PO YUAN CHEN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2026
Last Update Date: 08/29/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

254 EASTON AVE
NEW BRUNSWICK NJ
08901-1766
US

IV. Provider business mailing address

10 LANDING LN APT 6H
NEW BRUNSWICK NJ
08901-1041
US

V. Phone/Fax

Practice location:
  • Phone: 732-745-8600
  • Fax:
Mailing address:
  • Phone: 321-977-4495
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: