Provider Demographics
NPI:1306974449
Name:CHEN, JIANZHONG
Entity type:Individual
Prefix:
First Name:JIANZHONG
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150A TICES LN
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-2015
Mailing Address - Country:US
Mailing Address - Phone:732-254-5553
Mailing Address - Fax:732-238-6194
Practice Address - Street 1:150A TICES LN
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-2015
Practice Address - Country:US
Practice Address - Phone:732-254-5553
Practice Address - Fax:732-238-6194
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00009000171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist