Provider Demographics
NPI:1023447810
Name:CHEN, YONGJIE
Entity type:Individual
Prefix:
First Name:YONGJIE
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3804 COLUMBIA PIKE
Mailing Address - Street 2:APT 5
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-6408
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3804 COLUMBIA PIKE
Practice Address - Street 2:APT 5
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-6408
Practice Address - Country:US
Practice Address - Phone:732-829-6291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-02
Last Update Date:2014-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22776183500000X
NJ28RI03563700183500000X
PARP448243183500000X
MAPH234719183500000X
CA69442183500000X
TX53845183500000X
VA0202213483183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28RI03563700OtherBOARD OF PHARMACY
PARP448243OtherBOARD OF PHARMACY