Provider Demographics
NPI:1972055002
Name:CHEN, LI
Entity type:Individual
Prefix:
First Name:LI
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:644 PULLMAN PL
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-3355
Mailing Address - Country:US
Mailing Address - Phone:301-266-1654
Mailing Address - Fax:
Practice Address - Street 1:966 HUNGERFORD DR STE 15A
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-1743
Practice Address - Country:US
Practice Address - Phone:240-257-2882
Practice Address - Fax:855-978-2285
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-24
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01089171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist