Provider Demographics
NPI:1447202338
Name:CHUCK, ROY S JR (MD)
Entity Type:Individual
Prefix:
First Name:ROY
Middle Name:S
Last Name:CHUCK
Suffix:JR
Gender:M
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:111 EAST 210TH STREET
Mailing Address - Street 2:MONTEFIORE MEDICAL CENTER
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467
Mailing Address - Country:US
Mailing Address - Phone:718-920-4609
Mailing Address - Fax:718-881-5439
Practice Address - Street 1:111 EAST 210TH STREET
Practice Address - Street 2:MONTEFIORE MEDICAL CENTER
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467
Practice Address - Country:US
Practice Address - Phone:718-920-2020
Practice Address - Fax:718-881-5439
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2018-04-30
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Provider Licenses
StateLicense IDTaxonomies
NY253154-1207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03117333Medicaid
NY03117333Medicaid