Healthcare Provider Details

I. General information

NPI: 1023883568
Provider Name (Legal Business Name): DLC MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2023
Last Update Date: 11/15/2023
Certification Date: 11/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 LINK DR
ROCKLEIGH NJ
07647-2504
US

IV. Provider business mailing address

789 ONTARIO CT
FRANKLIN LAKES NJ
07417-2262
US

V. Phone/Fax

Practice location:
  • Phone: 201-784-1414
  • Fax:
Mailing address:
  • Phone: 917-319-3697
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID CHU
Title or Position: OWNER
Credential: MD
Phone: 917-319-3697