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General NPI Number Information
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NPI Number | 1932572880
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Entity Type | Organization
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Legal Business Name | BROOKLYN GASTROENTEROLOGY AND HEPATOLOGY PLLC
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Dates
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Enumeration Date | 10/31/2015
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Last Update Date | 04/20/2017
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Provider Practice Location Address
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Address Line | 2315 86TH ST
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City | BROOKLYN
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State | NY
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Zip | 11214-4309
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Country | US
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Telephone | 718-333-0093
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Fax |
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Provider Business Mailing Address
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Address Line | 2315 86TH ST
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City | BROOKLYN
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State | NY
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Zip | 11214-4309
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Country | US
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Telephone | 718-333-0093
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | POCHENG CHU
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Credential | M.D.
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Telephone | 718-808-3431
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 257725
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License Number State | NY
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