Basic Information
| Provider Information | |||||||||
| NPI: | 1285261115 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHEN | ||||||||
| FirstName: | FANGYU | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3400 SPRUCE ST. DULLES 5 DRIPPS LIBRARY | ||||||||
| Address2: | DULLES 5 DRIPPS LIBRARY | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2677584902 | ||||||||
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| Practice Location | |||||||||
| Address1: | 72 E CONCORD ST BLDG C515 | ||||||||
| Address2: | SURGICAL EDUCATION OFFICE | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021182642 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6176388442 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/23/2020 | ||||||||
| LastUpdateDate: | 07/25/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 285652 | MA | N | Allopathic & Osteopathic Physicians | Surgery | 207L00000X | MT222291 | PA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.