Provider Demographics
NPI:1912184169
Name:CHU, JOFFREY LIM (RPT)
Entity Type:Individual
Prefix:
First Name:JOFFREY
Middle Name:LIM
Last Name:CHU
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13620 38TH AVE
Mailing Address - Street 2:SUITE 7C
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-4232
Mailing Address - Country:US
Mailing Address - Phone:718-886-8606
Mailing Address - Fax:718-886-6985
Practice Address - Street 1:13620 38TH AVE
Practice Address - Street 2:SUITE 7C
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-4232
Practice Address - Country:US
Practice Address - Phone:718-886-8606
Practice Address - Fax:718-886-6985
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-29
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025263225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist