Provider Demographics
NPI:1114986130
Name:CHOU, LUCIA (MD)
Entity Type:Individual
Prefix:DR
First Name:LUCIA
Middle Name:
Last Name:CHOU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 MAIN ST
Mailing Address - Street 2:SUITE 3A
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06614-4946
Mailing Address - Country:US
Mailing Address - Phone:203-383-4323
Mailing Address - Fax:293-383-4325
Practice Address - Street 1:2900 MAIN ST
Practice Address - Street 2:SUITE 3A
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06614-4946
Practice Address - Country:US
Practice Address - Phone:203-383-4323
Practice Address - Fax:293-383-4325
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT027068207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001270686Medicaid
CTE28443Medicare UPIN
CT110007069Medicare ID - Type Unspecified