Provider Demographics
NPI:1902227903
Name:CHAN CHU, NANCY
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:CHAN 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 1:2 HUDSON PL STE 102
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-5515
Mailing Address - Country:US
Mailing Address - Phone:347-768-0938
Mailing Address - Fax:
Practice Address - Street 1:2 HUDSON PL STE 102
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-5515
Practice Address - Country:US
Practice Address - Phone:347-768-0938
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-18
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ18KT00058400225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist