Provider Demographics
NPI:1992980072
Name:CHEN, CHING YAU
Entity type:Individual
Prefix:
First Name:CHING YAU
Middle Name:
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 1:14 E MOUNT EDEN AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10452-5803
Mailing Address - Country:US
Mailing Address - Phone:917-862-9258
Mailing Address - Fax:
Practice Address - Street 1:61 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-5534
Practice Address - Country:US
Practice Address - Phone:845-775-4767
Practice Address - Fax:845-775-4767
Is Sole Proprietor?:No
Enumeration Date:2008-01-08
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034610183500000X
NY000619-01171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01731259Medicaid
NY1437647799OtherACUPUNCTURE