Provider Demographics
NPI:1588620322
Name:CHEN, JUNG-MING (MD)
Entity Type:Individual
Prefix:
First Name:JUNG-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 1:502 LINDELL AVE
Mailing Address - Street 2:
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-5452
Mailing Address - Country:US
Mailing Address - Phone:978-534-9198
Mailing Address - Fax:
Practice Address - Street 1:50 MEMORIAL DR
Practice Address - Street 2:SUITE 203
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-2238
Practice Address - Country:US
Practice Address - Phone:978-534-9488
Practice Address - Fax:978-534-3552
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA45238146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA045238OtherTUFTS HEALTH INS.
MA130586OtherHARVARD PILGRIM HEALTH CA
MA149440OtherHEALTH SOURCE MASSACHUSSE
MA18392OtherUNICARE HEALTH INS.
MA0107212Medicaid
MA0326OtherCENTRAL MASS HEALTH CARE
MA07-03063OtherUNITED HEALTH CARE
MA0014374OtherNEIGHBORHOOD HEALTH PLAN
MA4953OtherFALLON HEALTH CARE
MAS012044OtherCHAMPUS
MA36072OtherHEALTHY START PROGRAM
MA98798701OtherNETWORK HEALTH
MA0014374OtherNEIGHBORHOOD HEALTH PLAN
MA130586OtherHARVARD PILGRIM HEALTH CA