MEDICARE: MR. YI S CHEN DO

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	208600000X	Surgery Physician	205545	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	:	1750344255
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. YI S CHEN DO

Provider Business Mailing Address
First Line	:	13620 38TH AVE
Second Line	:	STE 6A
City	:	FLUSHING
State	:	NY
Zip	:	11354-4233
Country	:	US
Telephone Number	:	718-961-4636
Fax Number	:	718-461-5765

Provider Business Practice Location Address
First Line	:	13620 38TH AVE
Second Line	:	STE 6A
City	:	FLUSHING
State	:	NY
Zip	:	11354-4233
Country	:	US
Telephone Number	:	718-961-4636
Fax Number	:	718-461-5765

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

Provider Enumeration Date	:	04/07/2006
Last Update Date	:	06/25/2008

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Directions to “ MR. YI S CHEN DO” Practice Location

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