Provider Demographics
NPI:1811397870
Name:PETER CHIEN MD PLLC
Entity Type:Organization
Organization Name:PETER CHIEN MD PLLC
Other - Org Name:LUMOS DERMATOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-408-3376
Mailing Address - Street 1:200 E 27TH ST
Mailing Address - Street 2:UNIT 12W
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-9202
Mailing Address - Country:US
Mailing Address - Phone:917-408-3376
Mailing Address - Fax:
Practice Address - Street 1:37 E 28TH ST
Practice Address - Street 2:SUITE 304
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-7919
Practice Address - Country:US
Practice Address - Phone:646-820-1716
Practice Address - Fax:646-820-1716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-27
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY105318207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA100110906Medicare PIN