Healthcare Provider Details

I. General information

NPI: 1578599932
Provider Name (Legal Business Name): CHRISTOPHER WU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 04/12/2021
Certification Date: 04/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 E 70TH ST
NEW YORK NY
10021
US

IV. Provider business mailing address

GPO BOX 27578
NEW YORK NY
10087-7578
US

V. Phone/Fax

Practice location:
  • Phone: 212-606-1036
  • Fax:
Mailing address:
  • Phone: 631-329-6925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberD45598
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number183194
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License NumberD45598
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: