Healthcare Provider Details

I. General information

NPI: 1366890337
Provider Name (Legal Business Name): ADRIAN CHIU, PH.D., PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2016
Last Update Date: 03/29/2025
Certification Date: 03/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 BROOKSIDE AVE BLDG 4 STE 125
AMBLER PA
19002-3436
US

IV. Provider business mailing address

300 BROOKSIDE AVE BLDG 4 STE 125
AMBLER PA
19002-3436
US

V. Phone/Fax

Practice location:
  • Phone: 267-702-4862
  • Fax: 267-722-4362
Mailing address:
  • Phone: 267-702-4862
  • Fax: 267-722-4362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS017709
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberPS017709
License Number StatePA

VIII. Authorized Official

Name: ADRIAN CHIU
Title or Position: OWNER
Credential: PH.D.
Phone: 267-702-4862