Healthcare Provider Details

I. General information

NPI: 1972773802
Provider Name (Legal Business Name): DOLLY HSIAO-YING HSU-CHEN O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2008
Last Update Date: 03/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19121 GROTTO LN
GERMANTOWN MD
20874-1859
US

IV. Provider business mailing address

19121 GROTTO LN
GERMANTOWN MD
20874-1859
US

V. Phone/Fax

Practice location:
  • Phone: 301-728-6873
  • Fax:
Mailing address:
  • Phone: 301-728-6873
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberTA1871
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: