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Individual

DR. CLARENCE LEE CHEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
110 W 96TH ST, SUITE 1D, NEW YORK, NY 10025-6413
(212) 595-7189
(212) 595-7189
Mailing address
110 W 96TH ST, SUITE 1D, NEW YORK, NY 10025-6413
(212) 595-7189
(212) 595-7189

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
138749
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00712029
NY
01
0097224
GHI PROVIDER ID
NY
01
138749
MEDICAL LICENSE
NY
01
4289903
AETNA PROVIDER ID
NY
01
59005
MEDICAL LICENSE
NJ
01
79008946
DEPT OF HEALTH PIN
NY
01
P637365
OXFORD PROVIDER ID
NY
Enumeration date
05/15/2006
Last updated
03/07/2023
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