Healthcare Provider Details

I. General information

NPI: 1083437180
Provider Name (Legal Business Name): MR. TIANHE CHEN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2024
Last Update Date: 07/21/2025
Certification Date: 07/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8840 80TH ST BSMT
WOODHAVEN NY
11421-2405
US

IV. Provider business mailing address

8840 80TH ST BSMT
WOODHAVEN NY
11421-2405
US

V. Phone/Fax

Practice location:
  • Phone: 917-325-0318
  • Fax: 877-819-0389
Mailing address:
  • Phone: 917-325-0318
  • Fax: 877-819-0389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: