Provider Demographics
NPI:1821704917
Name:CHEN, LINGQIAO (PA)
Entity Type:Individual
Prefix:
First Name:LINGQIAO
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:7901 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-1329
Mailing Address - Country:US
Mailing Address - Phone:718-334-2698
Mailing Address - Fax:718-334-5006
Practice Address - Street 1:7901 BROADWAY
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-1329
Practice Address - Country:US
Practice Address - Phone:718-334-2698
Practice Address - Fax:718-334-5006
Is Sole Proprietor?:No
Enumeration Date:2023-01-23
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY029771363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant