Healthcare Provider Details

I. General information

NPI: 1982865101
Provider Name (Legal Business Name): JUDY CHIU DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2008
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 ALBANY TPKE BLDG 2
CANTON CT
06019-2516
US

IV. Provider business mailing address

47 PERRY DR
BURLINGTON CT
06013-1840
US

V. Phone/Fax

Practice location:
  • Phone: 860-269-3002
  • Fax: 860-255-4002
Mailing address:
  • Phone: 860-269-3002
  • Fax: 860-255-4002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number48298
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: