Provider Demographics
NPI:1568775344
Name:HE, CHONG (AP2713)
Entity Type:Individual
Prefix:DR
First Name:CHONG
Middle Name:
Last Name:HE
Suffix:
Gender:M
Credentials:AP2713
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 W BOYNTON BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-4022
Mailing Address - Country:US
Mailing Address - Phone:954-614-3609
Mailing Address - Fax:
Practice Address - Street 1:7559 NW 2ND CT
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2273
Practice Address - Country:US
Practice Address - Phone:954-614-3609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-21
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2713171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist