1902806813 NPI number — DR. CHERRIE C CHUA MD

Table of content: DR. CHERRIE C CHUA MD (NPI 1902806813)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902806813 NPI number — DR. CHERRIE C CHUA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHUA
Provider First Name:
CHERRIE
Provider Middle Name:
C
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CHUA-PO
Provider Other First Name:
CHERRIE
Provider Other Middle Name:
C
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1902806813
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/20/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
65 SPRINGFIELD RD
Provider Second Line Business Mailing Address:
WESTFIELD PEDIATRICS
Provider Business Mailing Address City Name:
WESTFIELD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01085-1855
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
413-562-8330
Provider Business Mailing Address Fax Number:
413-562-3430

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
65 SPRINGFIELD RD
Provider Second Line Business Practice Location Address:
WESTFIELD PEDIATRICS
Provider Business Practice Location Address City Name:
WESTFIELD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01085-1855
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-562-8330
Provider Business Practice Location Address Fax Number:
413-562-3430
Provider Enumeration Date:
07/21/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2080A0000X , with the licence number:  215726 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2000270 . This is a "MA MEDICAID - PCC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 215726 . This is a "CONNECTICARE OF MA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 043202198 . This is a "FIRST HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 043202198 . This is a "BEACH STREET" identifier . This identifiers is of the category "OTHER".
  • Identifier: J25781 . This is a "HMO BLUE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2000270 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4278616 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 043202198 . This is a "GREAT WEST HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 043202198 . This is a "HMC - PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: J25781 . This is a "BLUE CROSS BLUE SHEILD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 043202198 . This is a "CBA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 043202198 . This is a "CONSOLIDATED HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 043202198 . This is a "HEALTH CARE VALUE MANAGEM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0000000024681 . This is a "BOSTON MEDICAL CENTER - H" identifier . This identifiers is of the category "OTHER".
  • Identifier: 31784 . This is a "HEALTH NEW ENGLAND" identifier . This identifiers is of the category "OTHER".
  • Identifier: 42671 . This is a "CHILDRENS MEDICAL PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 043202198 . This is a "MULTIPLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 205892 . This is a "HARVARD/PILGRIM" identifier . This identifiers is of the category "OTHER".