Chen Yang, OD

Individual provider Active NPI Optometrist · JB MDL, NJ

NPI 1316249063 · NPPES record last updated Jul 21, 2022

Key facts

NPI
1316249063
Entity type
Individual (NPI type 1)
Primary specialty
Optometrist 152W00000X
License
OEG002843 (PA)
Practice address
3458 Neely Rd
JB MDL, NJ 08641-5312
Phone
(609) 754-9685
NPI assigned
Dec 1, 2010
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20150210002000 TX Order and Referring Only - Optometry
Practitioner - Optometry
5092030288

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG002843 PA Yes

Addresses

Primary practice location

3458 Neely Rd
JB MDL, NJ 08641-5312

Mailing address

52 Regency Dr
Mount Holly, NJ 08060-1379
Phone (210) 317-0915

Other providers in JB MDL, NJ

All providers in JB MDL, NJ · Optometrist in New Jersey

Sources for this page

Verify at the official NPI Registry.