Provider Demographics
NPI:1366556615
Name:CHEN, LUCY L (MD)
Entity type:Individual
Prefix:DR
First Name:LUCY
Middle Name:L
Last Name:CHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 MADISON AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-6389
Mailing Address - Country:US
Mailing Address - Phone:973-540-8814
Mailing Address - Fax:
Practice Address - Street 1:95 MADISON AVE STE 301
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6389
Practice Address - Country:US
Practice Address - Phone:973-540-8814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05936900207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5624304Medicaid
NJ748778Medicare ID - Type UnspecifiedMEDICARE
NJ5624304Medicaid