Provider Demographics
NPI:1346618832
Name:DR. CHEN OB/GYN P.A.
Entity Type:Organization
Organization Name:DR. CHEN OB/GYN P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:YING YING
Authorized Official - Middle Name:ALICE
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:954-725-7660
Mailing Address - Street 1:5350 W HILLSBORO BLVD
Mailing Address - Street 2:STE. 102
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-4396
Mailing Address - Country:US
Mailing Address - Phone:954-725-7660
Mailing Address - Fax:954-725-7605
Practice Address - Street 1:5350 W HILLSBORO BLVD
Practice Address - Street 2:STE. 102
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073-4396
Practice Address - Country:US
Practice Address - Phone:954-725-7660
Practice Address - Fax:954-725-7605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-14
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME68694174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL252850903Medicaid
FL252850903Medicaid
CG483AMedicare PIN