Provider Demographics
NPI:1356505127
Name:NEW LIFE RHEUMATOLOGY CENTER LLC
Entity Type:Organization
Organization Name:NEW LIFE RHEUMATOLOGY CENTER LLC
Other - Org Name:ALICE CHU MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RHEUMATOLOGYST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-778-6800
Mailing Address - Street 1:889 ALLWOOD RD
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07012-1933
Mailing Address - Country:US
Mailing Address - Phone:973-778-6800
Mailing Address - Fax:973-653-3028
Practice Address - Street 1:889 ALLWOOD RD
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07012-1933
Practice Address - Country:US
Practice Address - Phone:973-778-6800
Practice Address - Fax:973-653-3028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-11
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06229000174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ010062290NJ01OtherANTHEM HEALTH NETWORK
NJ1K3612OtherFIRST OPTION
NJ23161OtherUNITVERSITY HEALTH PLAN
NJ2376168OtherAETNA
NY02348901Medicaid
NY1799913OtherGHI
NJ7315503Medicaid
NJP611714OtherOXFORD
NJ1046529002OtherCIGNA
NJ1K5350OtherHEALTH NET
NY48J331OtherEMPIRE HMO
NJ5601313OtherAETNA TRADITIONAL PLAN
NJ32905OtherMASTER CARE
NY354AC1OtherEMPIRE PLANS ALL NY
NY48J33OtherEMPIRE PPO
NJCA4003OtherATLANTIS HEALTH PLAN
NJ010062290NJ01OtherANTHEM HEALTH NETWORK
NY02348901Medicaid
NJ088770Medicare PIN