Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | TUV007076-1 | NY |
NPI | 1003923509 |
---|---|
Provider Name | Dr. Janna Chen |
First Address | Staten Island, NY 10312-6511 |
Second Address | Staten Island, NY 10312-6511 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2006 |
Last Update Date | 15/07/2014 |