Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 25MA07815000 | NJ |
NPI | 1073747739 |
---|---|
Provider Name | Wei Chu |
First Address | Perth Amboy, NJ 08861-3396 |
Second Address | Perth Amboy, NJ 08861-4310 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2009 |
Last Update Date | 30/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0197360 | (05) | NJ |
G78513 | (02) | NJ |