Healthcare Provider Details

I. General information

NPI: 1205764404
Provider Name (Legal Business Name): JIAHUI CHEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JIA JOANNE CHEN

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 6TH ST
BROOKLYN NY
11215-3609
US

IV. Provider business mailing address

713 43RD ST APT 3B
BROOKLYN NY
11232-4211
US

V. Phone/Fax

Practice location:
  • Phone: 718-780-3000
  • Fax:
Mailing address:
  • Phone: 646-506-8687
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number813131
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: