Individual
JEFFREY CHIU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
4304 JUNCTION BLVD APT B, CORONA, NY 11368-0470
(718) 489-3119
(718) 899-3119
Mailing address
4304 JUNCTION BLVD APT B, CORONA, NY 11368-0470
(718) 489-3119
(718) 899-3119
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
01279801
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
828429420
DRIVER'S LICENSE
NY
Enumeration date
03/09/2021
Last updated
03/09/2021
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