1811085319 NPI number — DR. VIRGINIA L CHEN MD

Table of content: DR. VIRGINIA L CHEN MD (NPI 1811085319)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811085319 NPI number — DR. VIRGINIA L CHEN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHEN
Provider First Name:
VIRGINIA
Provider Middle Name:
L
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

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:
1811085319
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/04/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6 WARNKE LANE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SCARSDALE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10583
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
964-693-9550
Provider Business Mailing Address Fax Number:
212-986-3524

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1055 SAW MILL RIVER RD
Provider Second Line Business Practice Location Address:
203
Provider Business Practice Location Address City Name:
ARDSLEY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10502
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-693-9550
Provider Business Practice Location Address Fax Number:
212-986-3524
Provider Enumeration Date:
10/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207N00000X , with the licence number:  155603 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 4096474 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: N5354 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".




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