Provider Demographics
NPI:1215500947
Name:CHEN, GONGWEI (PHD)
Entity type:Individual
Prefix:
First Name:GONGWEI
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 ROYAL HUNT WAY
Mailing Address - Street 2:
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543-7614
Mailing Address - Country:US
Mailing Address - Phone:717-333-4484
Mailing Address - Fax:
Practice Address - Street 1:1547 MANHEIM PIKE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-3071
Practice Address - Country:US
Practice Address - Phone:717-333-4484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-20
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAF03839237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist