Provider Demographics
NPI:1295442671
Name:DAI, CHENZI (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CHENZI
Middle Name:
Last Name:DAI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 STEPHEN MOODY ST SE APT 1317
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87123-4029
Mailing Address - Country:US
Mailing Address - Phone:505-609-7039
Mailing Address - Fax:
Practice Address - Street 1:4700 CUTLER AVE NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-4096
Practice Address - Country:US
Practice Address - Phone:505-346-1661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-03
Last Update Date:2023-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00000103183500000X
NMRP00009802183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist