MEDICARE: KENNETH CHIU

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	058737	NY

General Provider Information

NPI Number	:	1083041107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENNETH CHIU

Provider Business Mailing Address
First Line	:	1822 74TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204
Country	:	US
Telephone Number	:	718-902-9016
Fax Number	:

Provider Business Practice Location Address
First Line	:	4915 FLATLANDS AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-2115
Country	:	US
Telephone Number	:	347-856-5852
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2013
Last Update Date	:	02/24/2016

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Directions to “ KENNETH CHIU ” Practice Location

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