Provider Demographics
NPI:1710142872
Name:CHIU, TED C (PTMS, MPA)
Entity Type:Individual
Prefix:MR
First Name:TED
Middle Name:C
Last Name:CHIU
Suffix:
Gender:M
Credentials:PTMS, MPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:274 W 145TH ST
Mailing Address - Street 2:310
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10039-4122
Mailing Address - Country:US
Mailing Address - Phone:212-368-7800
Mailing Address - Fax:212-368-7803
Practice Address - Street 1:274 W 145TH ST
Practice Address - Street 2:310
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10039-4122
Practice Address - Country:US
Practice Address - Phone:212-368-7800
Practice Address - Fax:212-368-7803
Is Sole Proprietor?:No
Enumeration Date:2008-07-28
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020223225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist