Healthcare Provider Details

I. General information

NPI: 1841879855
Provider Name (Legal Business Name): TIFFANY TINGSHUEN WU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2021
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 WOOSTER RD
ROCKY RIVER OH
44116-4164
US

IV. Provider business mailing address

111 NEW HAMPSHIRE AVE STE 2
PORTSMOUTH NH
03801-2864
US

V. Phone/Fax

Practice location:
  • Phone: 234-702-1244
  • Fax: 440-760-6596
Mailing address:
  • Phone: 330-947-6021
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number35.148691
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: