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NPI Code Detail

MEDICARE: DAVID CHEN MD

MEDICARE: DAVID CHEN MD
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
1390200000XStudent in an Organized Health Care Education/Training Program
22085R0202XDiagnostic Radiology Physician342934NY

General Provider Information

NPI Number : 1053998120
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID CHEN MD
Provider Business Mailing Address
First Line : 240 MEETING HOUSE LN
Second Line :
City : SOUTHAMPTON
State : NY
Zip : 11968-5009
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 101 NICOLLS RD
Second Line :
City : STONY BROOK
State : NY
Zip : 11794-0001
Country : US
Telephone Number : 631-444-5400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2021
Last Update Date : 06/01/2026

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Directions to “ DAVID CHEN MD” Practice Location

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