Provider Demographics
NPI:1992916589
Name:CHU, WYNATTE (DDS)
Entity type:Individual
Prefix:DR
First Name:WYNATTE
Middle Name:
Last Name:CHU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 PARK ROW
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-1146
Mailing Address - Country:US
Mailing Address - Phone:212-349-0760
Mailing Address - Fax:212-349-0761
Practice Address - Street 1:170 PARK ROW
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-1146
Practice Address - Country:US
Practice Address - Phone:212-349-0760
Practice Address - Fax:212-349-0761
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0512971223G0001X
CT0093141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice