Provider Demographics
NPI:1598138927
Name:CHIEN, DWIGHT C (LAC, DAC, PHD)
Entity Type:Individual
Prefix:
First Name:DWIGHT
Middle Name:C
Last Name:CHIEN
Suffix:
Gender:M
Credentials:LAC, DAC, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1146 RARITAN RD
Mailing Address - Street 2:
Mailing Address - City:CLARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07066-1312
Mailing Address - Country:US
Mailing Address - Phone:917-514-0997
Mailing Address - Fax:
Practice Address - Street 1:1146 RARITAN RD
Practice Address - Street 2:
Practice Address - City:CLARK
Practice Address - State:NJ
Practice Address - Zip Code:07066-1312
Practice Address - Country:US
Practice Address - Phone:917-514-0997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-06
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00115000171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist