Provider Demographics
NPI:1790084457
Name:CINDY CHEN MD PC
Entity Type:Organization
Organization Name:CINDY CHEN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-274-9870
Mailing Address - Street 1:139 CENTRE STREET
Mailing Address - Street 2:SUITE 505
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4555
Mailing Address - Country:US
Mailing Address - Phone:212-274-9870
Mailing Address - Fax:212-274-9499
Practice Address - Street 1:139 CENTRE STREET
Practice Address - Street 2:SUITE 505
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4555
Practice Address - Country:US
Practice Address - Phone:212-274-9870
Practice Address - Fax:212-274-9499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-21
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY211006208100000X
261QP2000X, 261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02021754Medicaid
NY88384Medicare PIN
NY02021754Medicaid