Provider Demographics
NPI:1760734131
Name:CHEN, YUNG-CHI (PHD)
Entity Type:Individual
Prefix:DR
First Name:YUNG-CHI
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:CLIFF
Other - Middle Name:
Other - Last Name:CHEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:4310 48TH AVE APT 6S
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-6204
Mailing Address - Country:US
Mailing Address - Phone:646-450-0938
Mailing Address - Fax:
Practice Address - Street 1:280 MADISON AVE
Practice Address - Street 2:SUITE 305B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-0801
Practice Address - Country:US
Practice Address - Phone:646-450-0938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-10
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019010103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist