Provider Demographics
NPI:1205340452
Name:CHEN, DORIS WENQIN (ACUPUNCTURIST)
Entity type:Individual
Prefix:
First Name:DORIS
Middle Name:WENQIN
Last Name:CHEN
Suffix:
Gender:F
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13837 JEWEL AVE APT 3C
Mailing Address - Street 2:
Mailing Address - City:KEW GARDENS HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11367-1982
Mailing Address - Country:US
Mailing Address - Phone:917-544-5940
Mailing Address - Fax:
Practice Address - Street 1:13837 JEWEL AVE APT 3C
Practice Address - Street 2:
Practice Address - City:KEW GARDENS HILLS
Practice Address - State:NY
Practice Address - Zip Code:11367-1982
Practice Address - Country:US
Practice Address - Phone:917-544-5940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-27
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005875171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist