=====================================================
General NPI Number Information
=====================================================
NPI Number | 1679825111
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | WEI CHEN PHARM.D
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/08/2012
-----------------------------------------------------
Last Update Date | 10/21/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 506 LENOX AVE
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10037-1802
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-939-8359
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 371 BROOME ST APT 15
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10013-3702
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-478-1990
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 057369
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------