Provider Demographics
NPI:1720217193
Name:CHEN, SHAN-CHIN (MD)
Entity Type:Individual
Prefix:
First Name:SHAN-CHIN
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:PO BOX 6054
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34611-6054
Mailing Address - Country:US
Mailing Address - Phone:917-599-7578
Mailing Address - Fax:800-420-3318
Practice Address - Street 1:2101 AVENUE X
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-2910
Practice Address - Country:US
Practice Address - Phone:718-517-2900
Practice Address - Fax:800-420-3318
Is Sole Proprietor?:No
Enumeration Date:2009-07-07
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2749622085R0001X, 2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology