Provider Demographics
NPI:1104396514
Name:CHEN, QIAN (NP)
Entity Type:Individual
Prefix:MS
First Name:QIAN
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16040 78TH RD
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11366-1945
Mailing Address - Country:US
Mailing Address - Phone:347-475-0911
Mailing Address - Fax:718-380-3441
Practice Address - Street 1:16040 78TH RD
Practice Address - Street 2:
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11366-1945
Practice Address - Country:US
Practice Address - Phone:347-475-0911
Practice Address - Fax:718-380-3441
Is Sole Proprietor?:No
Enumeration Date:2018-11-28
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF308825246ZN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZN0300XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherNephrology