Provider Demographics
NPI:1578507620
Name:CHIURCO, ANTHONY ALFRED (MD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:ALFRED
Last Name:CHIURCO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:54 CONSTITUTION HL W
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-6776
Mailing Address - Country:US
Mailing Address - Phone:609-895-8898
Mailing Address - Fax:609-895-8330
Practice Address - Street 1:3131 PRINCETON PIKE
Practice Address - Street 2:BUILDING 4, SUITE 201
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2201
Practice Address - Country:US
Practice Address - Phone:609-895-8898
Practice Address - Fax:609-895-8330
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA03134400207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJAC7868699OtherDEA LICENSE
NJD06845Medicare UPIN
NJAC7868699OtherDEA LICENSE