Healthcare Provider Details

I. General information

NPI: 1265255103
Provider Name (Legal Business Name): YU HANG CHEN RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2024
Last Update Date: 01/29/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12300 MCCRACKEN RD
GARFIELD HEIGHTS OH
44125-2914
US

IV. Provider business mailing address

12201 LARCHMERE BLVD APT 225
CLEVELAND OH
44120-1193
US

V. Phone/Fax

Practice location:
  • Phone: 216-581-0500
  • Fax:
Mailing address:
  • Phone: 917-365-7381
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN.CNP.0038558
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.493252
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: