Provider Demographics
NPI:1720285224
Name:CHEN, LILY Y (CA)
Entity Type:Individual
Prefix:
First Name:LILY
Middle Name:Y
Last Name:CHEN
Suffix:
Gender:F
Credentials:CA
Other - Prefix:
Other - First Name:LILY
Other - Middle Name:
Other - Last Name:CHEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CA
Mailing Address - Street 1:80 EAST RIDGEWOOD AVENUE
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652
Mailing Address - Country:US
Mailing Address - Phone:201-261-7122
Mailing Address - Fax:201-261-4419
Practice Address - Street 1:80 EAST RIDGEWOOD AVENUE
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652
Practice Address - Country:US
Practice Address - Phone:201-261-7122
Practice Address - Fax:201-261-4419
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2009-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ000129171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist