Provider Demographics
NPI:1841278579
Name:CHUA, VINCENT P (MD)
Entity type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:P
Last Name:CHUA
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Gender:M
Credentials:MD
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Mailing Address - Street 1:13336 41ST RD
Mailing Address - Street 2:SUITE 2M
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-3666
Mailing Address - Country:US
Mailing Address - Phone:718-463-0093
Mailing Address - Fax:718-463-0486
Practice Address - Street 1:13336 41ST RD
Practice Address - Street 2:SUITE 2M
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3666
Practice Address - Country:US
Practice Address - Phone:718-463-0093
Practice Address - Fax:718-463-0486
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-03
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NY204617207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F65660Medicare UPIN