Healthcare Provider Details

I. General information

NPI: 1700984150
Provider Name (Legal Business Name): RICHARD HSUEH WU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

169 RIVERSIDE DR
BINGHAMTON NY
13905-4246
US

IV. Provider business mailing address

169 RIVERSIDE DR
BINGHAMTON NY
13905-4246
US

V. Phone/Fax

Practice location:
  • Phone: 607-798-5524
  • Fax: 607-798-6164
Mailing address:
  • Phone: 607-798-5524
  • Fax: 607-798-6701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number107761
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: