Provider Demographics
NPI:1497800312
Name:WU, CHIA F (MD)
Entity Type:Individual
Prefix:DR
First Name:CHIA
Middle Name:F
Last Name:WU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-5526
Mailing Address - Country:US
Mailing Address - Phone:973-325-3445
Mailing Address - Fax:973-325-3507
Practice Address - Street 1:35 PARK AVE
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-5526
Practice Address - Country:US
Practice Address - Phone:973-325-3445
Practice Address - Fax:973-325-3507
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02689300207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MA02689300OtherSTATE LICENSE
NJ25MA02689300OtherSTATE LICENSE
NJD19707Medicare UPIN