MEDICARE: MICHELE CHEN

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
1	363LF0000X	Family Nurse Practitioner	338911	NY

General Provider Information

NPI Number	:	1063867695
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELE CHEN

Provider Business Mailing Address
First Line	:	4255 COLDEN ST
Second Line	:	APT 1U
City	:	FLUSHING
State	:	NY
Zip	:	11355-3937
Country	:	US
Telephone Number	:	917-543-4924
Fax Number	:

Provider Business Practice Location Address
First Line	:	4255 COLDEN ST
Second Line	:	APT 1U
City	:	FLUSHING
State	:	NY
Zip	:	11355-3937
Country	:	US
Telephone Number	:	917-543-4924
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/02/2016
Last Update Date	:	05/02/2016

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Directions to “ MICHELE CHEN ” Practice Location

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