Basic Information
| Provider Information | |||||||||
| NPI: | 1649352774 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHEN | ||||||||
| FirstName: | KATHY | ||||||||
| MiddleName: | DIANA | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 329 MULBERRY LN | ||||||||
| Address2: | |||||||||
| City: | ELKINS PARK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190271610 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2158861379 | ||||||||
| FaxNumber: | 2154276782 | ||||||||
| Practice Location | |||||||||
| Address1: | ERIE AVENUE AT FRONT STREET | ||||||||
| Address2: | ST. CHRISTOPHER'S HOSPITAL FOR CHILDREN, GASTRO | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2154276778 | ||||||||
| FaxNumber: | 2154276782 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/19/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080P0206X | MD-424334 | PA | Y | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Gastroenterology |
No ID Information.