=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194053371
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SHU-FEN CHEN M.A. P.T.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/25/2009
-----------------------------------------------------
Last Update Date | 11/25/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8238 212TH ST
-----------------------------------------------------
City | QUEENS VILLAGE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11427-1318
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-468-2257
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8238 212TH ST
-----------------------------------------------------
City | QUEENS VILLAGE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11427-1318
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-468-2257
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 017182-1
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------