Provider Demographics
NPI:1497199087
Name:CHEN, REBECCA (PA-C)
Entity type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1541 CHICHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:LINWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19061-4207
Mailing Address - Country:US
Mailing Address - Phone:610-485-1176
Mailing Address - Fax:610-485-6780
Practice Address - Street 1:1541 CHICHESTER AVE
Practice Address - Street 2:
Practice Address - City:LINWOOD
Practice Address - State:PA
Practice Address - Zip Code:19061-4207
Practice Address - Country:US
Practice Address - Phone:610-485-1176
Practice Address - Fax:610-485-6780
Is Sole Proprietor?:No
Enumeration Date:2013-04-25
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA056058363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical