Provider Demographics
NPI:1457419392
Name:CHEN, DECHENG (LAC PHD)
Entity Type:Individual
Prefix:DR
First Name:DECHENG
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:LAC PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 WEST 34 STREET
Mailing Address - Street 2:SUITE 903
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001
Mailing Address - Country:US
Mailing Address - Phone:212-564-3324
Mailing Address - Fax:212-564-3732
Practice Address - Street 1:1 W 34TH ST
Practice Address - Street 2:SUITE 903
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-3011
Practice Address - Country:US
Practice Address - Phone:212-564-3324
Practice Address - Fax:212-564-3732
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002021171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA3C9744OtherLANDMARK
NYP 3169363OtherOXFORD
MA9433943OtherPHCS