Individual
JIE CHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
245 N 15TH ST, MAIL STOP 435, PHILADELPHIA, PA 19102-1101
(215) 762-1179
(215) 762-1051
Mailing address
245 N 15TH ST, MAIL STOP 435, PHILADELPHIA, PA 19102-1101
(215) 762-1179
(215) 762-1051
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MT208720
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT208720
LICENSE NUMBER
PA
01
—
QH926570
CANADIAN PASSPORT
—
Enumeration date
07/06/2015
Last updated
07/06/2015
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