Provider Demographics
NPI:1487896817
Name:CHEN, YU-SHIAW (PHD, CN)
Entity type:Individual
Prefix:
First Name:YU-SHIAW
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:PHD, CN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 MAUREEN LN
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-2807
Mailing Address - Country:US
Mailing Address - Phone:631-751-4267
Mailing Address - Fax:
Practice Address - Street 1:11 MAUREEN LN
Practice Address - Street 2:
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11790-2807
Practice Address - Country:US
Practice Address - Phone:631-751-4267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-31
Last Update Date:2009-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO000847133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education