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NPI Code Detail

MEDICARE: DR. JANNA CHEN O.D.

MEDICARE: DR. JANNA CHEN O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometristTUV007076-1NY

General Provider Information

NPI Number : 1003923509
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JANNA CHEN O.D.
Provider Business Mailing Address
First Line : 23 OCEANIC AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10312-6511
Country : US
Telephone Number : 718-948-8880
Fax Number : 718-967-6040
Provider Business Practice Location Address
First Line : 23 OCEANIC AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10312-6511
Country : US
Telephone Number : 718-948-8880
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2006
Last Update Date : 01/08/2024

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