Provider Demographics
NPI:1629012281
Name:CHEN, ALICE C (OD)
Entity Type:Individual
Prefix:DR
First Name:ALICE
Middle Name:C
Last Name:CHEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 E 80TH ST
Mailing Address - Street 2:7C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-0531
Mailing Address - Country:US
Mailing Address - Phone:212-535-5619
Mailing Address - Fax:
Practice Address - Street 1:1491 3RD AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-2101
Practice Address - Country:US
Practice Address - Phone:212-396-4793
Practice Address - Fax:212-396-0125
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006416152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist