Healthcare Provider Details

I. General information

NPI: 1548723141
Provider Name (Legal Business Name): DAVINA CHEN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2019
Last Update Date: 07/14/2025
Certification Date: 07/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DEPT OF MEDICINE HSC LEVEL 16 SUNY STONY BROOK HOSPITAL
STONY BROOK NY
11794-0001
US

IV. Provider business mailing address

90 S BEDFORD RD
MOUNT KISCO NY
10549-3412
US

V. Phone/Fax

Practice location:
  • Phone: 631-444-2058
  • Fax: 631-444-2493
Mailing address:
  • Phone: 914-242-1370
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number330948
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number330948
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: