MEDICARE: JENNIFER CHIU MD

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	4351045521	MI

General Provider Information

NPI Number	:	1558923268
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER CHIU MD

Provider Business Mailing Address
First Line	:	300 LAFAYETTE AVE SE STE 4000
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49503-4692
Country	:	US
Telephone Number	:	616-685-6922
Fax Number	:

Provider Business Practice Location Address
First Line	:	5525 BROADWAY
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10463-5202
Country	:	US
Telephone Number	:	718-884-0279
Fax Number	:

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

Provider Enumeration Date	:	07/02/2019
Last Update Date	:	05/01/2026

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