Healthcare Provider Details

I. General information

NPI: 1629271754
Provider Name (Legal Business Name): SUNGKIN CHIU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2007
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13621 ROOSEVELT AVE STE 406
FLUSHING NY
11354-5507
US

IV. Provider business mailing address

3660 MAIN ST SUITE 2 S
FLUSHING NY
11354-6507
US

V. Phone/Fax

Practice location:
  • Phone: 718-888-1656
  • Fax: 718-886-2336
Mailing address:
  • Phone: 718-888-1656
  • Fax: 718-886-2336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number244265
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number244265
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: