Individual
BEVERLY CHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11 E BROADWAY, NEW YORK, NY 10038-1013
(212) 227-3088
Mailing address
11 E BROADWAY FL 13, NEW YORK, NY 10038-1013
(212) 227-3088
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
062081
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/05/2020
Last updated
01/10/2022
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