Provider Demographics
NPI:1760941744
Name:CHEN, SHUAI (FNP)
Entity Type:Individual
Prefix:
First Name:SHUAI
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:549 61ST ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-4605
Mailing Address - Country:US
Mailing Address - Phone:212-518-1669
Mailing Address - Fax:917-336-8422
Practice Address - Street 1:549 61ST ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-4605
Practice Address - Country:US
Practice Address - Phone:212-518-1669
Practice Address - Fax:917-336-8422
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-18
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY344131363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily