Healthcare Provider Details

I. General information

NPI: 1699965350
Provider Name (Legal Business Name): CHUI LING CHIU BU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2007
Last Update Date: 07/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 ELIZABETH ST SUITE 601
NEW YORK NY
10013-4803
US

IV. Provider business mailing address

8118 23RD AVE APT 3C
BROOKLYN NY
11214-2038
US

V. Phone/Fax

Practice location:
  • Phone: 212-966-8889
  • Fax:
Mailing address:
  • Phone: 646-464-3542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number205876
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: