Provider Demographics
NPI:1144877473
Name:CHEW, LOLITA L
Entity type:Individual
Prefix:
First Name:LOLITA
Middle Name:L
Last Name:CHEW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 SARNO ST
Mailing Address - Street 2:
Mailing Address - City:COLONIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07067-2117
Mailing Address - Country:US
Mailing Address - Phone:732-882-5585
Mailing Address - Fax:
Practice Address - Street 1:17 SARNO ST
Practice Address - Street 2:
Practice Address - City:COLONIA
Practice Address - State:NJ
Practice Address - Zip Code:07067-2117
Practice Address - Country:US
Practice Address - Phone:732-882-5585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-21
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00140800171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist