Provider Demographics
NPI:1033909692
Name:CHEN, JAMIE
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:CHEN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2065 60TH ST APT 2R
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-2437
Mailing Address - Country:US
Mailing Address - Phone:347-542-2658
Mailing Address - Fax:
Practice Address - Street 1:2065 60TH ST APT 2R
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-2437
Practice Address - Country:US
Practice Address - Phone:347-542-2658
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program