Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 161562 | NY |
NPI | 1346397023 |
---|---|
Provider Name | Dr. Mary Lynn Chu |
First Address | New York, NY 10021-4258 |
Second Address | New York, NY 10003-3804 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E62768 | (02) | NY |