Provider Demographics
NPI:1245330315
Name:CHEN, RUSI (MD)
Entity type:Individual
Prefix:DR
First Name:RUSI
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 1:336 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702
Mailing Address - Country:US
Mailing Address - Phone:508-872-7677
Mailing Address - Fax:508-875-8529
Practice Address - Street 1:336 UNION AVE
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702
Practice Address - Country:US
Practice Address - Phone:508-872-7677
Practice Address - Fax:508-875-8529
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA203744207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0108952Medicaid
MA0108952Medicaid
H21692Medicare UPIN