Provider Demographics
NPI:1316190333
Name:YUAN-FANG CHEN'S MEDICAL OFFICE P C
Entity type:Organization
Organization Name:YUAN-FANG CHEN'S MEDICAL OFFICE P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LI-HUA
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-886-8835
Mailing Address - Street 1:79 GILMAR LN
Mailing Address - Street 2:
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-2304
Mailing Address - Country:US
Mailing Address - Phone:718-886-8835
Mailing Address - Fax:718-886-8831
Practice Address - Street 1:33-70 PRINCE ST.
Practice Address - Street 2:CA-18
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354
Practice Address - Country:US
Practice Address - Phone:718-886-8835
Practice Address - Fax:718-886-8831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-04
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225375-1261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center