Provider Demographics
NPI:1710142872
Name:CHIU, TED C (PTMS, MPA)
Entity type:Individual
Prefix:MR
First Name:TED
Middle Name:C
Last Name:CHIU
Suffix:
Gender:M
Credentials:PTMS, MPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4415 PURVES ST APT 9C
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-2972
Mailing Address - Country:US
Mailing Address - Phone:917-589-4467
Mailing Address - Fax:
Practice Address - Street 1:1981 JEROME AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-1803
Practice Address - Country:US
Practice Address - Phone:917-589-4467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020223225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist