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NPI Code Detail

MEDICARE: JUSTIN CHUA MD

MEDICARE: JUSTIN CHUA MD
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
1207Q00000XFamily Medicine Physician306036-01NY
2207Q00000XFamily Medicine PhysicianMT212671PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1154856755
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUSTIN CHUA MD
Provider Business Mailing Address
First Line : 111 CLOCK TOWER CMNS
Second Line :
City : BREWSTER
State : NY
Zip : 10509-4055
Country : US
Telephone Number : 845-279-5187
Fax Number : 855-703-7570
Provider Business Practice Location Address
First Line : 111 CLOCK TOWER CMNS
Second Line :
City : BREWSTER
State : NY
Zip : 10509-4055
Country : US
Telephone Number : 845-279-5187
Fax Number : 855-703-7570
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2017
Last Update Date : 01/28/2026

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Directions to “ JUSTIN CHUA MD” Practice Location

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