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NPI Code Detail

MEDICARE: JESSICA CHIU

MEDICARE: JESSICA CHIU
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist067083NY

General Provider Information

NPI Number : 1104425016
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA CHIU
Provider Business Mailing Address
First Line : 4734 46TH ST
Second Line :
City : WOODSIDE
State : NY
Zip : 11377-6552
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 757 3RD AVE
Second Line :
City : NEW YORK
State : NY
Zip : 10017-2013
Country : US
Telephone Number : 212-758-4627
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/21/2020
Last Update Date : 10/21/2020

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Directions to “ JESSICA CHIU ” Practice Location

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