Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 055117 | NY |
NPI | 1225269954 |
---|---|
Provider Name | Dr. Christine Chu |
First Address | Clifton, NJ 07014-1914 |
Second Address | New York, NY 10010-4020 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2009 |
Last Update Date | 19/09/2017 |