Provider Demographics
NPI:1922073071
Name:CHEN, WEIHENG (OD PHD)
Entity Type:Individual
Prefix:
First Name:WEIHENG
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:OD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14904-2948
Mailing Address - Country:US
Mailing Address - Phone:607-767-6655
Mailing Address - Fax:607-737-4694
Practice Address - Street 1:1600 CEDAR ST
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14904-2948
Practice Address - Country:US
Practice Address - Phone:607-767-6655
Practice Address - Fax:607-737-4694
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-22
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA008914152W00000X
NYTUV006607152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02431749Medicaid
PA077526Medicare ID - Type Unspecified