Provider Demographics
NPI:1740280171
Name:CHEN, YANFENG (MD)
Entity type:Individual
Prefix:
First Name:YANFENG
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 1:5517 7TH AVE
Mailing Address - Street 2:1F
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-3519
Mailing Address - Country:US
Mailing Address - Phone:718-871-8255
Mailing Address - Fax:718-871-8255
Practice Address - Street 1:5517 7TH AVE
Practice Address - Street 2:1F
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-3519
Practice Address - Country:US
Practice Address - Phone:718-871-8255
Practice Address - Fax:718-438-2736
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-28
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY192848207R00000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01663285Medicaid
NY02H552Medicare ID - Type Unspecified
NYF79859Medicare UPIN