Provider Demographics
NPI:1487852331
Name:CHARLES S TIU DDS PC
Entity type:Organization
Organization Name:CHARLES S TIU DDS PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:S
Authorized Official - Last Name:TIU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:212-571-2656
Mailing Address - Street 1:8 CHATHAM SQUARE
Mailing Address - Street 2:ROOM 300
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-1000
Mailing Address - Country:US
Mailing Address - Phone:212-571-2656
Mailing Address - Fax:212-571-2657
Practice Address - Street 1:8 CHATHAM SQUARE
Practice Address - Street 2:ROOM 300
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-1000
Practice Address - Country:US
Practice Address - Phone:212-571-2656
Practice Address - Fax:212-571-2657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-03
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041453122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty