Provider Demographics
NPI:1639436496
Name:CHU, JONATHAN SIU-ON (MD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:SIU-ON
Last Name:CHU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 ST. CHARLES WAY
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402
Mailing Address - Country:US
Mailing Address - Phone:717-812-2212
Mailing Address - Fax:
Practice Address - Street 1:228 SAINT CHARLES WAY STE 300
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-4661
Practice Address - Country:US
Practice Address - Phone:717-812-2055
Practice Address - Fax:717-741-3784
Is Sole Proprietor?:No
Enumeration Date:2012-04-18
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD457819208100000X, 2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty