1457738452 NPI number — RENWU CHEN LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457738452 NPI number — RENWU CHEN LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RENWU CHEN LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1457738452
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 LAKESTONE CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROCKVILLE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20850-5406
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1400 FOREST GLEN RD
Provider Second Line Business Practice Location Address:
225
Provider Business Practice Location Address City Name:
SILVER SPRING
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20910-1459
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
240-715-5508
Provider Business Practice Location Address Fax Number:
301-260-2838
Provider Enumeration Date:
04/29/2015

Additional Information

Authorized Official

Authorized Official Last Name:
CHEN
Authorized Official First Name:
RENWU
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
240-715-5508

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  D0073831 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com