Provider Demographics
NPI:1891484259
Name:CHU, CAITLYN
Entity Type:Individual
Prefix:MS
First Name:CAITLYN
Middle Name:
Last Name:CHU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 FRONT ST UNIT 1109
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608-1447
Mailing Address - Country:US
Mailing Address - Phone:301-640-6525
Mailing Address - Fax:
Practice Address - Street 1:145 FRONT ST UNIT 1109
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1447
Practice Address - Country:US
Practice Address - Phone:301-640-6525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-02
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant