Provider Demographics
NPI:1790770642
Name:CHEN, MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 PROGRESS ST # 37
Mailing Address - Street 2:SUITE B-2
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-1179
Mailing Address - Country:US
Mailing Address - Phone:908-754-9292
Mailing Address - Fax:732-463-6082
Practice Address - Street 1:35 PROGRESS ST # 37
Practice Address - Street 2:SUITE B-2
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-1179
Practice Address - Country:US
Practice Address - Phone:908-754-9292
Practice Address - Fax:732-463-6082
Is Sole Proprietor?:No
Enumeration Date:2005-09-16
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA33616207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0560502Medicaid
NJ0560502Medicaid
NJ411903Medicare PIN