Provider Demographics
NPI:1790067767
Name:CHEN, JIAN
Entity Type:Individual
Prefix:
First Name:JIAN
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 MORRIS PARK AVE
Mailing Address - Street 2:ALBERT EINSTEIN COL MED, FORCHEIMER BUILDING, ROOM 103
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-1900
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1300 MORRIS PARK AVE
Practice Address - Street 2:ALBERT EINSTEIN COL MED, FORCHEIMER BUILDING, ROOM 103
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1900
Practice Address - Country:US
Practice Address - Phone:646-775-0396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-15
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program