Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 060253 | NY |
NPI | 1114459328 |
---|---|
Provider Name | Yan Chen |
First Address | New City, NY 10956-4234 |
Second Address | New York, NY 10010-4020 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2017 |
Last Update Date | 15/12/2019 |