Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 25MA02073800 | NJ |
NPI | 1023076403 |
---|---|
Provider Name | Vivian Chen |
First Address | East Brunswick, NJ 08816 |
Second Address | East Brunswick, NJ 08816 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 08/07/2007 |