Provider Demographics
NPI:1689969933
Name:CHEN, CHING-HUA (LAC, MSTOM, ADS)
Entity Type:Individual
Prefix:MR
First Name:CHING-HUA
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:LAC, MSTOM, ADS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 VAN CORTLANDT PARK S
Mailing Address - Street 2:APT 6M
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-2435
Mailing Address - Country:US
Mailing Address - Phone:718-406-2315
Mailing Address - Fax:
Practice Address - Street 1:3800 PUTNAM AVENUE WEST
Practice Address - Street 2:BRONX ACUPUNCTURE P.C.
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-2435
Practice Address - Country:US
Practice Address - Phone:718-549-1987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-15
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004536-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist