Provider Demographics
NPI:1962602136
Name:CHEN, WILLIAM CHUN-YING (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:CHUN-YING
Last Name:CHEN
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 1:440 E MAIN ST STE C
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-8501
Mailing Address - Country:US
Mailing Address - Phone:855-927-6622
Mailing Address - Fax:516-470-8445
Practice Address - Street 1:440 E MAIN ST STE C
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706
Practice Address - Country:US
Practice Address - Phone:855-927-6622
Practice Address - Fax:516-470-8445
Is Sole Proprietor?:No
Enumeration Date:2007-07-24
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY268572-42085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03807430Medicaid