Provider Demographics
NPI:1902035595
Name:CHEN, MAMIE ZENG (OD)
Entity Type:Individual
Prefix:DR
First Name:MAMIE
Middle Name:ZENG
Last Name:CHEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 YORK ST
Mailing Address - Street 2:1ST FLOOR LOWER LEVEL
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-3838
Mailing Address - Country:US
Mailing Address - Phone:201-855-9789
Mailing Address - Fax:
Practice Address - Street 1:66 YORK ST
Practice Address - Street 2:1ST FLOOR LOWER LEVEL
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-3838
Practice Address - Country:US
Practice Address - Phone:201-855-9789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-05
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00629600152W00000X
NYTUV 007408152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist