Provider Demographics
NPI:1891041307
Name:CHU, CHRISTINA AI-LING (OD)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:AI-LING
Last Name:CHU
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30-267 MALL DR. WEST
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07310
Mailing Address - Country:US
Mailing Address - Phone:201-798-0303
Mailing Address - Fax:201-798-6021
Practice Address - Street 1:30-267 MALL DR. WEST
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07310
Practice Address - Country:US
Practice Address - Phone:201-798-0303
Practice Address - Fax:201-798-6021
Is Sole Proprietor?:No
Enumeration Date:2012-08-02
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00641000152W00000X
NY007889152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist