Healthcare Provider Details

I. General information

NPI: 1043837974
Provider Name (Legal Business Name): TAMMY CHEN DDS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2020
Last Update Date: 06/26/2020
Certification Date: 06/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W 57TH ST STE 303
NEW YORK NY
10019-3211
US

IV. Provider business mailing address

200 W 57TH ST STE 303
NEW YORK NY
10019-3211
US

V. Phone/Fax

Practice location:
  • Phone: 212-601-2666
  • Fax:
Mailing address:
  • Phone: 212-601-2666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: TAMMY CHEN
Title or Position: PRESIDENT
Credential:
Phone: 212-601-2666