Provider Demographics
NPI:1235135476
Name:CHEN, ANDREW L (MD, MS)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:L
Last Name:CHEN
Suffix:
Gender:M
Credentials:MD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 160
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:NH
Mailing Address - Zip Code:03561-0160
Mailing Address - Country:US
Mailing Address - Phone:603-823-8600
Mailing Address - Fax:603-823-8688
Practice Address - Street 1:1095 PROFILE ROAD
Practice Address - Street 2:
Practice Address - City:FRANCONIA
Practice Address - State:NH
Practice Address - Zip Code:03580
Practice Address - Country:US
Practice Address - Phone:603-823-8600
Practice Address - Fax:603-823-8688
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH12418174400000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30204642Medicaid
NH6058360001Medicare NSC
RE791101Medicare PIN
NH30204642Medicaid