Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | MA069462 | NJ |
NPI | 1598883571 |
---|---|
Provider Name | Serena H Chen |
First Address | Livingston, NJ 07039 |
Second Address | Livingston, NJ 07039 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10703138 | CAQH (01) |