Basic Information
| Provider Information | |||||||||
| NPI: | 1720217193 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHEN | ||||||||
| FirstName: | SHAN-CHIN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 405 E 56TH ST | ||||||||
| Address2: | APT 7-O | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100222412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9175997578 | ||||||||
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| Practice Location | |||||||||
| Address1: | 10614 70TH AVE | ||||||||
| Address2: | |||||||||
| City: | FOREST HILLS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113754253 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7185206620 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2009 | ||||||||
| LastUpdateDate: | 07/28/2014 | ||||||||
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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 | 2085R0001X | 274962 | NY | Y | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology |
No ID Information.