Provider Demographics
NPI:1194799791
Name:CHEN, KAI-MAY (OD)
Entity type:Individual
Prefix:
First Name:KAI-MAY
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9958 74TH AVE
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-6806
Mailing Address - Country:US
Mailing Address - Phone:646-435-2835
Mailing Address - Fax:
Practice Address - Street 1:18012 UNION TPKE
Practice Address - Street 2:
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11366-1620
Practice Address - Country:US
Practice Address - Phone:718-380-5353
Practice Address - Fax:718-380-5396
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-13
Last Update Date:2014-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV006686-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC304C1Medicare ID - Type Unspecified
NYU98797Medicare UPIN