Provider Demographics
NPI:1700277019
Name:CHEN, CYNTHIA (DO)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 DEKALB AVE
Mailing Address - Street 2:SURGERY DEPT
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-2205
Mailing Address - Country:US
Mailing Address - Phone:718-250-6839
Mailing Address - Fax:718-250-6080
Practice Address - Street 1:240 WILLOUGHBY STREET
Practice Address - Street 2:SUITE 8E
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201
Practice Address - Country:US
Practice Address - Phone:718-250-6920
Practice Address - Fax:718-250-6080
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-09
Last Update Date:2020-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY300144-01208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery