Provider Demographics
NPI:1891794723
Name:CHU, GARY YIU-KIN (OD MPH)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:YIU-KIN
Last Name:CHU
Suffix:
Gender:M
Credentials:OD MPH
Other - Prefix:DR
Other - First Name:YIU-KIN
Other - Middle Name:GARY
Other - Last Name:CHU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:930 COMMONWEALTH AVE
Mailing Address - Street 2:SUITE 2A NEW ENGLAND EYE INSTITUTE
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215
Mailing Address - Country:US
Mailing Address - Phone:617-262-2020
Mailing Address - Fax:617-236-6323
Practice Address - Street 1:930 COMMONWEALTH AVE
Practice Address - Street 2:SUITE 2A NEW ENGLAND EYE INSTITUTE
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215
Practice Address - Country:US
Practice Address - Phone:617-262-2020
Practice Address - Fax:617-236-6323
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2015-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3911152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA324361Medicaid
MAW17023Medicare ID - Type Unspecified
MA324361Medicaid