Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 285278 | NY |
NPI | 1033397666 |
---|---|
Provider Name | Dr. Jason Chiu |
First Address | New York, NY 10022-4971 |
Second Address | New York, NY 10022-4971 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2008 |
Last Update Date | 21/08/2020 |