Provider Demographics
NPI:1053342576
Name:CHEN, ALBERT K (MD)
Entity type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:K
Last Name:CHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:852 UPLAND DRIVE
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14905-1421
Mailing Address - Country:US
Mailing Address - Phone:607-732-0921
Mailing Address - Fax:607-732-0921
Practice Address - Street 1:361 W WATER ST
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14905-2519
Practice Address - Country:US
Practice Address - Phone:607-733-0780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1101052084P0800X
NY110105MD2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00399000Medicaid
NYB81487Medicare UPIN