Healthcare Provider Details

I. General information

NPI: 1336585082
Provider Name (Legal Business Name): NICOLE FAITH CHEN CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2013
Last Update Date: 07/03/2025
Certification Date: 07/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 WHITE PLAINS RD STE 500
TARRYTOWN NY
10591-5118
US

IV. Provider business mailing address

520 WHITE PLAINS RD STE 500
TARRYTOWN NY
10591-5118
US

V. Phone/Fax

Practice location:
  • Phone: 845-426-4686
  • Fax: 469-242-9559
Mailing address:
  • Phone: 845-426-4686
  • Fax: 469-242-9559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number557748
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberN500007183
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number25ME00090400
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number25ME00090401
License Number StateNJ
# 5
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberCNM500007183
License Number StateDC
# 6
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number063533
License Number StateNY
# 7
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number001548
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: