Provider Demographics
NPI:1598771370
Name:LOWE, CHUN KYU (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:CHUN
Middle Name:KYU
Last Name:LOWE
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:DR
Other - First Name:CHUN
Other - Middle Name:KYU
Other - Last Name:LOH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:200 GRAND AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 GRAND AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-4371
Practice Address - Country:US
Practice Address - Phone:201-568-8411
Practice Address - Fax:201-568-5367
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA36027208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3846008Medicaid
NJ3846008Medicaid
NJC56808Medicare UPIN