Provider Demographics
NPI:1750344255
Name:CHEN, YI S (DO)
Entity type:Individual
Prefix:MR
First Name:YI
Middle Name:S
Last Name:CHEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:13620 38TH AVE
Mailing Address - Street 2:STE 6A
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-4233
Mailing Address - Country:US
Mailing Address - Phone:718-961-4636
Mailing Address - Fax:718-461-5765
Practice Address - Street 1:13620 38TH AVE
Practice Address - Street 2:STE 6A
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-4233
Practice Address - Country:US
Practice Address - Phone:718-961-4636
Practice Address - Fax:718-461-5765
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2008-06-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY205545208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0213167120Medicaid
NY04557Medicare PIN
H35367Medicare UPIN