Provider Demographics
NPI:1699865832
Name:POON, CHIU-MAN (MD)
Entity type:Individual
Prefix:DR
First Name:CHIU-MAN
Middle Name:
Last Name:POON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2780 MORRIS AVE
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-4852
Mailing Address - Country:US
Mailing Address - Phone:908-687-3300
Mailing Address - Fax:908-687-4747
Practice Address - Street 1:2780 MORRIS AVE
Practice Address - Street 2:SUITE 2A
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-4852
Practice Address - Country:US
Practice Address - Phone:908-687-3300
Practice Address - Fax:908-687-4747
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05702100208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5495407Medicaid
NJ5495407Medicaid
NJPO025893Medicare ID - Type Unspecified