Provider Demographics
NPI:1982100715
Name:CHEN, LIANG (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:LIANG
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:549 FAIR ST # MC61-22
Mailing Address - Street 2:
Mailing Address - City:BLOOMSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17815-1419
Mailing Address - Country:US
Mailing Address - Phone:570-416-1925
Mailing Address - Fax:570-387-6185
Practice Address - Street 1:549 FAIR ST # MC61-22
Practice Address - Street 2:
Practice Address - City:BLOOMSBURG
Practice Address - State:PA
Practice Address - Zip Code:17815-1419
Practice Address - Country:US
Practice Address - Phone:570-416-1925
Practice Address - Fax:570-387-6185
Is Sole Proprietor?:No
Enumeration Date:2018-04-02
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT215365207R00000X, 208100000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program