Provider Demographics
NPI:1295489995
Name:CHEN, MICHELLE HSIEN YUN (PHD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:HSIEN YUN
Last Name:CHEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CENTER GROVE RD APT 9-6
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:NJ
Mailing Address - Zip Code:07869-4436
Mailing Address - Country:US
Mailing Address - Phone:609-742-1828
Mailing Address - Fax:
Practice Address - Street 1:100 CENTER GROVE RD APT 9-6
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:NJ
Practice Address - Zip Code:07869-4436
Practice Address - Country:US
Practice Address - Phone:609-742-1828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-10
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024039103G00000X
NJ35SI00663900103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist