Provider Demographics
NPI:1912130618
Name:DR. CHEN OB/GYN P.A.
Entity Type:Organization
Organization Name:DR. CHEN OB/GYN P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:YING YING
Authorized Official - Middle Name:ALICE
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-971-6789
Mailing Address - Street 1:5800 COLONIAL DR
Mailing Address - Street 2:#303
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-5682
Mailing Address - Country:US
Mailing Address - Phone:954-971-6789
Mailing Address - Fax:954-971-6161
Practice Address - Street 1:5800 COLONIAL DR
Practice Address - Street 2:#303
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-5682
Practice Address - Country:US
Practice Address - Phone:954-971-6789
Practice Address - Fax:954-971-6161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-27
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL252850903Medicaid
FL00042773Medicare PIN
FLG18664Medicare UPIN