Provider Demographics
NPI:1649335811
Name:THLICK, AI-EN CHU (MD)
Entity type:Individual
Prefix:
First Name:AI-EN
Middle Name:CHU
Last Name:THLICK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4533 NEW FALLS RD
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19056-3004
Mailing Address - Country:US
Mailing Address - Phone:267-540-8220
Mailing Address - Fax:609-537-7072
Practice Address - Street 1:4533 NEW FALLS RD
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19056-3004
Practice Address - Country:US
Practice Address - Phone:267-540-8220
Practice Address - Fax:609-537-7072
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD431886207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine