1245236611 NPI number — DR. JIAN CHU YU MD

Table of content: (NPI 1548362411)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245236611 NPI number — DR. JIAN CHU YU MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
YU
Provider First Name:
JIAN
Provider Middle Name:
CHU
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1245236611
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/28/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
236 CEDRUS AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EAST NORTHPORT
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11731-4515
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
631-368-1142
Provider Business Mailing Address Fax Number:
631-368-1113

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
227 MOUNT PLEASANT ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAUPPAUGE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11788-2900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-360-0005
Provider Business Practice Location Address Fax Number:
631-368-1113
Provider Enumeration Date:
06/21/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208C00000X , with the licence number:  144252 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0054209 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 020023863 . This is a "RR MEDICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: DO8585 . This is a "OXFORD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0614257-005 . This is a "CIGNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 11632 . This is a "VYTRA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 27153P . This is a "HIP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 56A913 . This is a "BCBS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 144252B28 . This is a "HEALTH FIRST" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 40C2983 . This is a "HEALTHNET" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 112219566 . This is a "EMPIRE PLAN, NYSHIP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1168009 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 144252 . This is a "HIP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1442525 . This is a "HEALTHCARE PARTNER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 183279 . This is a "AETNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 112219566 . This is a "CIGNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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