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NPI Code Detail

MEDICARE: JOLINA JIAYING CHEN PA-C

MEDICARE: JOLINA JIAYING CHEN PA-C
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
1363A00000XPhysician Assistant029745NY

General Provider Information

NPI Number : 1477254993
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOLINA JIAYING CHEN PA-C
Provider Business Mailing Address
First Line : 1430 BERGEN ST APT 1I
Second Line :
City : BROOKLYN
State : NY
Zip : 11213-1645
Country : US
Telephone Number : 718-772-1048
Fax Number :
Provider Business Practice Location Address
First Line : 5604 7TH AVE STE 1
Second Line :
City : BROOKLYN
State : NY
Zip : 11220-4660
Country : US
Telephone Number : 917-508-5888
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/13/2023
Last Update Date : 03/13/2023

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