1255187415 NPI number — JUNYU CHEN PELVIC FLOOR PT P.C.

Table of content: (NPI 1255187415)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255187415 NPI number — JUNYU CHEN PELVIC FLOOR PT P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JUNYU CHEN PELVIC FLOOR PT P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1255187415
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/17/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6434 GRAND CENTRAL PKWY APT 1H
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FOREST HILLS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11375-1585
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
917-698-9878
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13336 41ST RD STE 2A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FLUSHING
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11355-3666
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
646-509-8789
Provider Business Practice Location Address Fax Number:
516-407-5622
Provider Enumeration Date:
04/29/2024

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CHEN
Authorized Official First Name:
JUNYU
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
646-509-9789

Provider Taxonomy Codes

  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)