Basic Information
| Provider Information | |||||||||
| NPI: | 1649244898 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHEN | ||||||||
| FirstName: | FREDERICK | ||||||||
| MiddleName: | YEN-CHING | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D., PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 594 NEWTON ST | ||||||||
| Address2: | |||||||||
| City: | CHESTNUT HILL | ||||||||
| State: | MA | ||||||||
| PostalCode: | 024673177 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177327775 | ||||||||
| FaxNumber: | 6177326559 | ||||||||
| Practice Location | |||||||||
| Address1: | 75 FRANCIS ST | ||||||||
| Address2: | CARDIAC SURGERY | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021156110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177327775 | ||||||||
| FaxNumber: | 6177326559 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/15/2006 | ||||||||
| LastUpdateDate: | 09/13/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208G00000X | 214043 | MA | Y | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
ID Information
| ID | Type | State | Issuer | Description | 0034349 | 01 | MA | NHP | OTHER | 2097630 | 05 | MA | MEDICAID | J28299 | 01 | MA | BCBS HMO/PPO/BC65 | OTHER | AA24183 | 01 | MA | HPHC | OTHER | 5707717 | 01 | MA | AETNA PPO | OTHER | 18-00246 | 01 | MA | UNITED | OTHER | 467726 | 01 | MA | TAHP | OTHER | 3700736 | 01 | MA | AETNA HMO | OTHER | 3707915 | 01 | MA | CIGNA | OTHER |