Healthcare Provider Details

I. General information

NPI: 1467842682
Provider Name (Legal Business Name): SOPHIA Y CHEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2015
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 1ST AVE STE 7V
NEW YORK NY
10016-6402
US

IV. Provider business mailing address

530 1ST AVE STE 7V
NEW YORK NY
10016-6402
US

V. Phone/Fax

Practice location:
  • Phone: 646-501-0584
  • Fax: 646-501-9995
Mailing address:
  • Phone: 646-501-0584
  • Fax: 646-501-9995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number334776
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: