Provider Demographics
NPI:1811036593
Name:CHINTA TONY CHIU MD. PC.
Entity Type:Organization
Organization Name:CHINTA TONY CHIU MD. PC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:CHINTA
Authorized Official - Middle Name:TONY
Authorized Official - Last Name:CHIU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-886-1664
Mailing Address - Street 1:13360 41ST AVE
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-5852
Mailing Address - Country:US
Mailing Address - Phone:718-886-1664
Mailing Address - Fax:718-886-1943
Practice Address - Street 1:13360 41ST AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-5811
Practice Address - Country:US
Practice Address - Phone:718-886-1884
Practice Address - Fax:718-886-1943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY214850207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01997502Medicaid
NY03774Medicare ID - Type Unspecified
NY01997502Medicaid