Basic Information
| Provider Information | |||||||||
| NPI: | 1255544086 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHEN | ||||||||
| FirstName: | WEN | ||||||||
| MiddleName: | HSIANG | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1265 FRANKLIN AVE | ||||||||
| Address2: | |||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104563501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7185037700 | ||||||||
| FaxNumber: | 7185037712 | ||||||||
| Practice Location | |||||||||
| Address1: | 1265 FRANKLIN AVE | ||||||||
| Address2: | |||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104563501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7185037700 | ||||||||
| FaxNumber: | 7185037712 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/08/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 112728 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.