MEDICARE: AKKC MEDICINE LLC

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1093366684
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AKKC MEDICINE LLC

Provider Business Mailing Address
First Line	:	364 LAFAYETTE AVE
Second Line	:
City	:	HAWTHORNE
State	:	NJ
Zip	:	07506-2545
Country	:	US
Telephone Number	:	973-595-8800
Fax Number	:

Provider Business Practice Location Address
First Line	:	364 LAFAYETTE AVE
Second Line	:
City	:	HAWTHORNE
State	:	NJ
Zip	:	07506-2545
Country	:	US
Telephone Number	:	973-595-8800
Fax Number	:

Authorized Official
Title or Position	:	PARTNER/OWNER
Name	:	DR. KRYSTLE CHUA
Credential	:	MD
Telephone Number	:	973-820-7700

Provider Enumeration Date	:	09/25/2019
Last Update Date	:	05/21/2025

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Directions to “AKKC MEDICINE LLC ” Practice Location

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