MEDICARE: HONG 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	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1689921934
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HONG CHEN

Provider Business Mailing Address
First Line	:	356 BAY RIDGE AVE FL 1
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-5315
Country	:	US
Telephone Number	:	347-740-1559
Fax Number	:

Provider Business Practice Location Address
First Line	:	356 BAY RIDGE AVE FL 1
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-5315
Country	:	US
Telephone Number	:	347-740-1559
Fax Number	:

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

Provider Enumeration Date	:	08/06/2012
Last Update Date	:	08/06/2012

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Directions to “ HONG CHEN ” Practice Location

Language	Start Address	Practice Location

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