Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 231269 | NY |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | MA08 | NJ |
NPI | 1346416997 |
---|---|
Provider Name | Dr. Alice Chu |
First Address | Newark, NJ 07107-3000 |
Second Address | Newark, NJ 07103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2008 |
Last Update Date | 09/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0247561 | (05) | NJ |