Healthcare Provider Details

I. General information

NPI: 1528556123
Provider Name (Legal Business Name): CHEN ZHOU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2018
Last Update Date: 09/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

833 CHESTNUT ST STE 210
PHILADELPHIA PA
19107-4405
US

IV. Provider business mailing address

833 CHESTNUT ST STE 210
PHILADELPHIA PA
19107-4405
US

V. Phone/Fax

Practice location:
  • Phone: 215-955-8420
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMT215522
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: