Provider Demographics
NPI:1578507745
Name:CHEN, CHUN MING (MD)
Entity Type:Individual
Prefix:
First Name:CHUN MING
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 1:3916 PRINCE ST STE 353
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-5367
Mailing Address - Country:US
Mailing Address - Phone:646-912-1823
Mailing Address - Fax:718-559-6965
Practice Address - Street 1:3916 PRINCE ST STE 353
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5367
Practice Address - Country:US
Practice Address - Phone:646-912-1823
Practice Address - Fax:718-559-6965
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY223423207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02321626Medicaid
NYG400000288Medicare Oscar/Certification
NYH69380Medicare UPIN
NY5284UHMedicare ID - Type Unspecified