Provider Demographics
NPI:1568558922
Name:CHU, EMILY YUAN-TIAN I (OD)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:YUAN-TIAN
Last Name:CHU
Suffix:I
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8556 VALLEY WEST DR
Mailing Address - Street 2:
Mailing Address - City:BREINIGSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18031-4131
Mailing Address - Country:US
Mailing Address - Phone:347-239-4802
Mailing Address - Fax:
Practice Address - Street 1:7285 YELLOWSTONE BLVD
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4133
Practice Address - Country:US
Practice Address - Phone:347-239-4802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV006676152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU99180Medicare UPIN