Provider Demographics
NPI:1558485284
Name:CHEN, CINDY GX (PHD)
Entity Type:Individual
Prefix:DR
First Name:CINDY
Middle Name:GX
Last Name:CHEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15155 40TH AVE N
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55446-3236
Mailing Address - Country:US
Mailing Address - Phone:763-205-3622
Mailing Address - Fax:763-205-3622
Practice Address - Street 1:15155 40TH AVE N
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55446-3236
Practice Address - Country:US
Practice Address - Phone:763-205-3622
Practice Address - Fax:763-205-3622
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171100000X
MN1331171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYOXFORD HEALTH PLAN POtherACUPUNCTURE
NYEMPIRE PPO &EPOZG575OtherACUPUNCTURE
MNHPFIN 125041OtherACUPUNCTURE