Provider Demographics
NPI:1831298801
Name:CHEN, AILIAN (MD)
Entity Type:Individual
Prefix:
First Name:AILIAN
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1302 KINGS HWY
Mailing Address - Street 2:FL 5
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229
Mailing Address - Country:US
Mailing Address - Phone:718-258-2655
Mailing Address - Fax:
Practice Address - Street 1:1302 KINGS HWY
Practice Address - Street 2:FL 5
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1964
Practice Address - Country:US
Practice Address - Phone:718-258-2655
Practice Address - Fax:718-258-2664
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY197199207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01729973Medicaid
G33465Medicare UPIN
NY01729973Medicaid