Healthcare Provider Details

I. General information

NPI: 1932015476
Provider Name (Legal Business Name): QUEENS NEUROLOGY AND NEUROMUSCULAR MEDICINE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3640 MAIN ST STE 203
FLUSHING NY
11354-6521
US

IV. Provider business mailing address

3640 MAIN ST STE 203
FLUSHING NY
11354-6521
US

V. Phone/Fax

Practice location:
  • Phone: 718-888-0980
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ANNIE S WU
Title or Position: OWNER
Credential: MD
Phone: 718-888-0980