Provider Demographics
NPI:1861472474
Name:CHIU, PRISCILLA P (MD)
Entity Type:Individual
Prefix:DR
First Name:PRISCILLA
Middle Name:P
Last Name:CHIU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:955 E HAVERFORD ROAD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010
Mailing Address - Country:US
Mailing Address - Phone:610-525-2990
Mailing Address - Fax:610-525-2099
Practice Address - Street 1:600 HAVERFORD RD
Practice Address - Street 2:
Practice Address - City:HAVERFORD
Practice Address - State:PA
Practice Address - Zip Code:19041-1139
Practice Address - Country:US
Practice Address - Phone:610-525-2990
Practice Address - Fax:610-525-2099
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD425410207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101325219Medicaid
PA232359401OtherMAIN LINE HEALTHCARE
PA093107EGWMedicare PIN
I35984Medicare UPIN
PA101325219Medicaid