Provider Demographics
NPI:1982865101
Name:CHIU, JUDY (DO)
Entity type:Individual
Prefix:DR
First Name:JUDY
Middle Name:
Last Name:CHIU
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 PERRY DR
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06013-1840
Mailing Address - Country:US
Mailing Address - Phone:860-269-3002
Mailing Address - Fax:860-255-4002
Practice Address - Street 1:30 W AVON RD
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:CT
Practice Address - Zip Code:06001-3678
Practice Address - Country:US
Practice Address - Phone:860-269-3002
Practice Address - Fax:860-255-4002
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-20
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT48298207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1982865101OtherNPI