Provider Demographics
NPI:1366682312
Name:CHEN, YI-WEN (RPA/C)
Entity Type:Individual
Prefix:
First Name:YI-WEN
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:RPA/C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16303 HORACE HARDING EXPY
Mailing Address - Street 2:5TH FLOOR
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11365-1454
Mailing Address - Country:US
Mailing Address - Phone:718-888-9121
Mailing Address - Fax:
Practice Address - Street 1:16303 HORACE HARDING EXPY
Practice Address - Street 2:5TH FLOOR
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11365-1454
Practice Address - Country:US
Practice Address - Phone:718-888-9121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-04
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007611363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0271IXMedicare PIN
P77240Medicare UPIN
NY0271IWMedicare PIN