Individual
SUSIE CHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
99 BEAUVOIR AVE, SUMMIT, NJ 07901-3533
(908) 522-2065
(908) 522-5763
Mailing address
PO BOX 412826, BOSTON, MA 02241-2526
(610) 892-8889
(484) 446-8005
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
240269-1
NY
2085R0202X
Diagnostic Radiology Physician
Primary
25MA07573500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02186203
MEDICAID GROUP #
NY
01
—
W35021
MEDICARE GROUP #
NY
Enumeration date
08/03/2006
Last updated
11/03/2023
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