Healthcare Provider Details

I. General information

NPI: 1225597198
Provider Name (Legal Business Name): JESSICA TU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2019
Last Update Date: 10/25/2024
Certification Date: 10/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 WATER ST FL 46
NEW YORK NY
10041-3211
US

IV. Provider business mailing address

185 S ORANGE AVE
NEWARK NJ
07103-2757
US

V. Phone/Fax

Practice location:
  • Phone: 212-649-5555
  • Fax:
Mailing address:
  • Phone: 732-445-4636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number314323
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number324313
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: