MEDICARE: LI FANG CHEN MS

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	174400000X	Specialist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	174400000X	OTHER		SPECIAL EDUCATION

General Provider Information

NPI Number	:	1184334393
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LI FANG CHEN MS

Provider Business Mailing Address
First Line	:	2423 W 2ND ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11223-5919
Country	:	US
Telephone Number	:	917-880-0685
Fax Number	:

Provider Business Practice Location Address
First Line	:	2423 W 2ND ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11223-5919
Country	:	US
Telephone Number	:	917-880-0685
Fax Number	:

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

Provider Enumeration Date	:	11/29/2022
Last Update Date	:	11/29/2022

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