Provider Demographics
NPI:1225175193
Name:CHUA, JOSELITA (MD)
Entity Type:Individual
Prefix:
First Name:JOSELITA
Middle Name:
Last Name:CHUA
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 1:12500 EDGEWATER DR
Mailing Address - Street 2:#1402
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-1677
Mailing Address - Country:US
Mailing Address - Phone:216-227-1199
Mailing Address - Fax:
Practice Address - Street 1:12500 EDGEWATER DR
Practice Address - Street 2:#1402
Practice Address - City:LAKEWOOD
Practice Address - State:OH
Practice Address - Zip Code:44107-1677
Practice Address - Country:US
Practice Address - Phone:216-227-1199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350805382084P0800X
CAA881642084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH35080538OtherLICENSE
CAA88164OtherLICENSE
OHBC7658036OtherDEA NUMBER
OH35080538OtherLICENSE