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NPI Code Detail

MEDICARE: MISS ELAINE VIVIAN CHU O.D.

MEDICARE:  MISS ELAINE VIVIAN CHU  O.D.
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
1152W00000XOptometrist270A00628600NJ
2152W00000XOptometristTUV007650NY

General Provider Information

NPI Number : 1285935205
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS ELAINE VIVIAN CHU O.D.
Provider Business Mailing Address
First Line : 3 PLUM TREE CT
Second Line :
City : EAST BRUNSWICK
State : NJ
Zip : 08816-5241
Country : US
Telephone Number : 908-616-4146
Fax Number :
Provider Business Practice Location Address
First Line : 169 1ST AVE
Second Line :
City : NEW YORK
State : NY
Zip : 10003-2927
Country : US
Telephone Number : 212-460-9240
Fax Number : 212-253-0764
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2010
Last Update Date : 03/14/2016

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Directions to “ MISS ELAINE VIVIAN CHU O.D.” Practice Location

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