Provider Demographics
NPI:1649352774
Name:CHEN, KATHY DIANA (MD)
Entity type:Individual
Prefix:DR
First Name:KATHY
Middle Name:DIANA
Last Name:CHEN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:329 MULBERRY LN
Mailing Address - Street 2:
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-1610
Mailing Address - Country:US
Mailing Address - Phone:215-886-1379
Mailing Address - Fax:215-427-6782
Practice Address - Street 1:ERIE AVENUE AT FRONT STREET
Practice Address - Street 2:ST. CHRISTOPHER'S HOSPITAL FOR CHILDREN, GASTRO
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134
Practice Address - Country:US
Practice Address - Phone:215-427-6778
Practice Address - Fax:215-427-6782
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
PAMD-4243342080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAI-13727Medicare UPIN