Healthcare Provider Details
I. General information
NPI: 1174502504
Provider Name (Legal Business Name): CYNTHIA XINYUE LIU-CHEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/13/2006
Last Update Date: 07/22/2023
Certification Date: 07/22/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
100 HITCHCOCK WAY. DEPT OF INTERNAL MEDICINE, DARTMOUTH HITCHCOCK CLINICS
MANCHESTER NH
03104
US
IV. Provider business mailing address
100 HITCHCOCK WAY. DEPT OF INTERNAL MEDICINE, DARTMOUTH HITCHCOCK CLINICS
MANCHESTER NH
03104
US
V. Phone/Fax
- Phone: 603-695-2600
- Fax: 603-308-1470
- Phone: 603-695-2600
- Fax: 603-308-1470
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 242474 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QG0300X |
| Taxonomy | Geriatric Medicine (Family Medicine) Physician |
| License Number | 242474 |
| License Number State | NY |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 24027 |
| License Number State | NH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: