Provider Demographics
NPI:1326605981
Name:CHEN, ALBERT (DPT)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8136 COLERAINE CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-2729
Mailing Address - Country:US
Mailing Address - Phone:858-805-1802
Mailing Address - Fax:
Practice Address - Street 1:1009 STADIUM DR # 124
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-4673
Practice Address - Country:US
Practice Address - Phone:919-453-5910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-20
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP18874225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist