Healthcare Provider Details

I. General information

NPI: 1548764624
Provider Name (Legal Business Name): LESLEY WU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2018
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 SOMERSET ST
NEW BRUNSWICK NJ
08901
US

IV. Provider business mailing address

165 SOMERSET ST
NEW BRUNSWICK NJ
08901
US

V. Phone/Fax

Practice location:
  • Phone: 848-379-4200
  • Fax:
Mailing address:
  • Phone: 848-379-4200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number25MA13090600
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number1019340
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number1019340
License Number StateMA
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number1548764624
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: