Healthcare Provider Details

I. General information

NPI: 1720167364
Provider Name (Legal Business Name): EILEEN T CHEN MEDICAL P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 02/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 CHATHAM SQ SUITE 700
NEW YORK NY
10038-1000
US

IV. Provider business mailing address

7 CHATHAM SQ SUITE 700
NEW YORK NY
10038-1000
US

V. Phone/Fax

Practice location:
  • Phone: 212-766-9180
  • Fax: 212-766-9181
Mailing address:
  • Phone: 212-766-9180
  • Fax: 212-766-9181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number175596
License Number StateNY

VIII. Authorized Official

Name: EILEEN CHEN
Title or Position: OWNER
Credential: M.D.
Phone: 212-766-9180