Provider Demographics
NPI:1891209771
Name:CHEN, QIUPING (OM)
Entity Type:Individual
Prefix:
First Name:QIUPING
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BRITTON PL STE 3
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-2514
Mailing Address - Country:US
Mailing Address - Phone:856-271-3668
Mailing Address - Fax:
Practice Address - Street 1:1 BRITTON PL STE 3
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-2514
Practice Address - Country:US
Practice Address - Phone:856-271-3668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-30
Last Update Date:2021-06-21
Deactivation Date:2017-11-30
Deactivation Code:
Reactivation Date:2018-03-08
Provider Licenses
StateLicense IDTaxonomies
PAOM000211171100000X
NJ25MZ00135800171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist