Provider Demographics
NPI:1316189350
Name:CHEN, LEON M
Entity type:Individual
Prefix:MR
First Name:LEON
Middle Name:M
Last Name:CHEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 WHITE PLAINS RD FL 4
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-5139
Mailing Address - Country:US
Mailing Address - Phone:914-984-2546
Mailing Address - Fax:
Practice Address - Street 1:802 64TH ST
Practice Address - Street 2:SUITE 3A-E
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-4730
Practice Address - Country:US
Practice Address - Phone:718-748-5225
Practice Address - Fax:718-680-8360
Is Sole Proprietor?:No
Enumeration Date:2009-04-06
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY258968207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400108055Medicare PIN