Healthcare Provider Details

I. General information

NPI: 1326763533
Provider Name (Legal Business Name): JESSIE JIE CHEN LMT,LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JIE CHEN

II. Dates (important events)

Enumeration Date: 10/10/2022
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 HOLLYBERRY RD
PLAINVIEW NY
11803-2621
US

IV. Provider business mailing address

3 HOLLYBERRY RD
PLAINVIEW NY
11803-2621
US

V. Phone/Fax

Practice location:
  • Phone: 718-316-5334
  • Fax:
Mailing address:
  • Phone: 516-779-5017
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number007606-01
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number032861-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: