Provider Demographics
NPI:1457650350
Name:CHEN, TRICIA TYA (LPN)
Entity Type:Individual
Prefix:MISS
First Name:TRICIA
Middle Name:TYA
Last Name:CHEN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 NORTH AVE
Mailing Address - Street 2:PH
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10805-3505
Mailing Address - Country:US
Mailing Address - Phone:646-384-5808
Mailing Address - Fax:
Practice Address - Street 1:23 NORTH AVE
Practice Address - Street 2:PH
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10805-3505
Practice Address - Country:US
Practice Address - Phone:646-384-5808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-18
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY304925-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse