Provider Demographics
NPI:1699196121
Name:CHEN, ANDREW (MS OTRL)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:MS OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 CARRIAGE DR
Mailing Address - Street 2:
Mailing Address - City:WERNERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19565-9483
Mailing Address - Country:US
Mailing Address - Phone:484-332-2816
Mailing Address - Fax:
Practice Address - Street 1:8 CARRIAGE DR
Practice Address - Street 2:
Practice Address - City:WERNERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19565-9483
Practice Address - Country:US
Practice Address - Phone:484-332-2816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-31
Last Update Date:2013-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC012523225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist