Provider Demographics
NPI:1144260019
Name:CHU, DAVID SC (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:SC
Last Name:CHU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:255 LAKE RD
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960
Mailing Address - Country:US
Mailing Address - Phone:973-644-3545
Mailing Address - Fax:
Practice Address - Street 1:90 BERGEN ST
Practice Address - Street 2:STE 6100
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103
Practice Address - Country:US
Practice Address - Phone:973-972-2064
Practice Address - Fax:973-972-2068
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07286500207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1801176920OtherGROUP NPI NUMBER
NJ453030846OtherTAX IDENTIFICATION NUMBER
NY460945805OtherTAX IDENTIFICATION NUMBER
NJ8591407Medicaid
NJ453030846OtherTAX IDENTIFICATION NUMBER
NY460945805OtherTAX IDENTIFICATION NUMBER