Basic Information
| Provider Information | |||||||||
| NPI: | 1225534415 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHEN | ||||||||
| FirstName: | ANTHONY | ||||||||
| MiddleName: | G. | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 416457 | ||||||||
| Address2: | |||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 022416457 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8443621735 | ||||||||
| FaxNumber: | 9732907495 | ||||||||
| Practice Location | |||||||||
| Address1: | 281 STATE ROUTE 34 STE 813 | ||||||||
| Address2: | |||||||||
| City: | COLTS NECK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 077222440 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7324312620 | ||||||||
| FaxNumber: | 7324312620 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/05/2018 | ||||||||
| LastUpdateDate: | 11/07/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/07/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 25MB11482400 | NJ | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.