Provider Demographics
NPI:1265471767
Name:CHEN, C JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:C JAMES
Middle Name:
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 1:2121 MAIN ST
Mailing Address - Street 2:SUITE 218
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14214-2693
Mailing Address - Country:US
Mailing Address - Phone:716-833-9568
Mailing Address - Fax:716-833-9588
Practice Address - Street 1:2121 MAIN ST
Practice Address - Street 2:SUITE 218
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14214-2693
Practice Address - Country:US
Practice Address - Phone:716-833-9568
Practice Address - Fax:716-833-9588
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY109836207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0700349OtherIHA
NY000502296001OtherBCBS
NY00611803Medicaid
NY040426000739OtherFIDELIS
NY00010029201OtherUNIVERA
NY00010029201OtherUNIVERA
NY0700349OtherIHA