Provider Demographics
NPI:1225131238
Name:CHEN, CHING LYNN (MD)
Entity Type:Individual
Prefix:
First Name:CHING
Middle Name:LYNN
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 1:620 COLUMBUS AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-1458
Mailing Address - Country:US
Mailing Address - Phone:212-580-3866
Mailing Address - Fax:212-580-3867
Practice Address - Street 1:620 COLUMBUS AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-1458
Practice Address - Country:US
Practice Address - Phone:212-580-3866
Practice Address - Fax:212-580-3867
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY216216174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY76N441Medicare ID - Type Unspecified