MEDICARE: BO CHEN M.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
1	207R00000X	Internal Medicine Physician	200331	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356434104
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BO CHEN M.D

Provider Business Mailing Address
First Line	:	98 E BROADWAY
Second Line	:	LOWER LEVEL
City	:	NEW YORK
State	:	NY
Zip	:	10002-7181
Country	:	US
Telephone Number	:	212-343-9261
Fax Number	:	212-343-9718

Provider Business Practice Location Address
First Line	:	98 E BROADWAY
Second Line	:	LOWER LEVEL
City	:	NEW YORK
State	:	NY
Zip	:	10002-7181
Country	:	US
Telephone Number	:	212-343-9261
Fax Number	:	212-343-9718

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

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	08/05/2011

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Directions to “ BO CHEN M.D” Practice Location

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