MEDICARE: EUGENE CHIN

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	363LA2100X	Acute Care Nurse Practitioner	431993	NY

General Provider Information

NPI Number	:	1154903789
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EUGENE CHIN

Provider Business Mailing Address
First Line	:	1102 49TH AVE APT 2G
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-5658
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1102 49TH AVE APT 2G
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-5658
Country	:	US
Telephone Number	:	718-887-1338
Fax Number	:

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

Provider Enumeration Date	:	04/23/2021
Last Update Date	:	04/23/2021

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Directions to “ EUGENE CHIN ” Practice Location

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