Provider Demographics
NPI:1114001880
Name:CHIU, DAVID TAK WAI (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:TAK WAI
Last Name:CHIU
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 1:12 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708-3129
Mailing Address - Country:US
Mailing Address - Phone:212-879-8880
Mailing Address - Fax:212-879-8050
Practice Address - Street 1:900 PARK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-0231
Practice Address - Country:US
Practice Address - Phone:212-879-8880
Practice Address - Fax:212-879-8050
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1317552082S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY33F411Medicare ID - Type Unspecified
CO9782Medicare UPIN