Provider Demographics
NPI:1750585287
Name:CHU, DAVID TIN (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:TIN
Last Name:CHU
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1500 ROUTE 112 BLDG 4
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11776-8055
Mailing Address - Country:US
Mailing Address - Phone:631-751-3000
Mailing Address - Fax:631-675-2001
Practice Address - Street 1:49 NESCONSET HWY
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON STATION
Practice Address - State:NY
Practice Address - Zip Code:11776-2628
Practice Address - Country:US
Practice Address - Phone:631-751-3000
Practice Address - Fax:631-675-2001
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2020-01-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY250808207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03094680Medicaid
NY11303OtherMAGNACARE
NY7C2423OtherHEALTHNET
NY014CE1OtherBLUE SHIELD
NY250808-A10OtherHEALTHFIRST
NY8259306OtherCIGNA
NY091202000087OtherFIDELIS CARE OF NY
NYP00750946OtherRR MEDICARE
NYP4082661OtherOXFORD
NY201009000016OtherAFFINITY
NY4584734OtherAETNA
NY8259306OtherCIGNA