Individual
FANG CHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
496 COUNTY ROAD 111, BUILDING B, MANORVILLE, NY 11949-3383
(631) 405-3200
(631) 395-6010
Mailing address
185 OLD COUNTRY RD, STE 2, RIVERHEAD, NY 11901-2121
(631) 298-4479
(631) 591-3047
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
239293
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02900750
—
NY
Enumeration date
03/19/2007
Last updated
01/16/2014
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