Healthcare Provider Details

I. General information

NPI: 1679141360
Provider Name (Legal Business Name): YAN LOK CHU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2021
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 MANCHESTER AVE STE 102
FORKED RIVER NJ
08731-1366
US

IV. Provider business mailing address

987 BEDFORD AVE APT 2
BROOKLYN NY
11205-5271
US

V. Phone/Fax

Practice location:
  • Phone: 201-972-6138
  • Fax:
Mailing address:
  • Phone: 617-642-8511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: