Provider Demographics
NPI:1255653853
Name:CHIU, CHINGIN TIM (B,S)
Entity Type:Individual
Prefix:
First Name:CHINGIN
Middle Name:TIM
Last Name:CHIU
Suffix:
Gender:M
Credentials:B,S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14720 35TH AVE
Mailing Address - Street 2:APT 5D
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-3700
Mailing Address - Country:US
Mailing Address - Phone:917-373-9241
Mailing Address - Fax:
Practice Address - Street 1:310 CENTRAL AVE
Practice Address - Street 2:SUITE#111
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018-2835
Practice Address - Country:US
Practice Address - Phone:973-674-5777
Practice Address - Fax:973-674-5999
Is Sole Proprietor?:No
Enumeration Date:2010-02-23
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJRI02926500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist