Most Relevant Information
Provider Data
| NPI Number: | 1003510447 |
| Provider Name: | JUSTIN CHEN |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/29/2023 |
| Last Updated: | 03/29/2023 |
Provider Practice Location
445 SEAVIEW AVENUE
STATEN ISLAND
NY
10305
Practice Location Phone/Fax
| Phone: | 7182268313 |
| Fax: |
Provider Mailing Location
445 SEAVIEW AVENUE
STATEN ISLAND
NY
10305
Provider Mailing Phone/Fax
| Phone: | 7182268313 |
| Fax: |