Provider Demographics
NPI:1164415899
Name:CHEN, THOMAS T (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:T
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 1:3907 PRINCE ST
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-5321
Mailing Address - Country:US
Mailing Address - Phone:718-661-1783
Mailing Address - Fax:718-661-1772
Practice Address - Street 1:3907 PRINCE ST
Practice Address - Street 2:SUITE 3A
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5321
Practice Address - Country:US
Practice Address - Phone:718-661-1783
Practice Address - Fax:718-661-1772
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY185166207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1854008Medicaid
NY1854008Medicaid
NY06578GMedicare ID - Type Unspecified