Provider Demographics
NPI:1063439941
Name:LIEN, MARCUS CHENCHI (MD)
Entity type:Individual
Prefix:DR
First Name:MARCUS
Middle Name:CHENCHI
Last Name:LIEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2649 STRANG BLVD STE 304
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-2938
Mailing Address - Country:US
Mailing Address - Phone:914-739-0087
Mailing Address - Fax:914-737-1714
Practice Address - Street 1:2649 STRANG BLVD STE 304
Practice Address - Street 2:
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-2938
Practice Address - Country:US
Practice Address - Phone:914-739-0087
Practice Address - Fax:914-737-1714
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-16
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY306373207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8483844Medicaid
WAMD00047409OtherWA STATE LICENSE
WAP00466599OtherRAILROAD MEDICARE
WA0220888OtherLABOR & INDUSTRY
WAP00466599OtherRAILROAD MEDICARE
WAG8878693Medicare PIN