Healthcare Provider Details

I. General information

NPI: 1699862466
Provider Name (Legal Business Name): JIE CHEN O.M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11120 NEW HAMPAHIRE AVE SUITE 409
SILVER SPRING MD
20904
US

IV. Provider business mailing address

11120 NEW HAMPSHIRE AVE STE 409
SILVER SPRING MD
20904-2620
US

V. Phone/Fax

Practice location:
  • Phone: 301-335-6155
  • Fax: 301-947-8097
Mailing address:
  • Phone: 301-335-6155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberU00564
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: