Provider Demographics
NPI:1881090751
Name:CHIU, ADRIAN (PHD)
Entity type:Individual
Prefix:
First Name:ADRIAN
Middle Name:
Last Name:CHIU
Suffix:
Gender:
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 BROOKSIDE AVE BLDG 4 STE 125
Mailing Address - Street 2:
Mailing Address - City:AMBLER
Mailing Address - State:PA
Mailing Address - Zip Code:19002-3436
Mailing Address - Country:US
Mailing Address - Phone:267-702-4862
Mailing Address - Fax:267-722-4362
Practice Address - Street 1:300 BROOKSIDE AVE BLDG 4 STE 125
Practice Address - Street 2:
Practice Address - City:AMBLER
Practice Address - State:PA
Practice Address - Zip Code:19002-3436
Practice Address - Country:US
Practice Address - Phone:267-702-4862
Practice Address - Fax:267-722-4362
Is Sole Proprietor?:No
Enumeration Date:2014-11-05
Last Update Date:2025-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS017709103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
510200Medicare PIN