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General NPI Number Information
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NPI Number | 1003141573
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Entity Type | Organization
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Legal Business Name | CTU MEDICAL PC
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Dates
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Enumeration Date | 10/16/2009
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Last Update Date | 02/15/2010
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Provider Practice Location Address
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Address Line | 837 58TH ST FL 5TH
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City | BROOKLYN
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State | NY
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Zip | 11220-3662
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Country | US
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Telephone | 718-853-2828
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Fax | 718-975-0040
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Provider Business Mailing Address
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Address Line | 837 58TH ST FL 5
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City | BROOKLYN
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State | NY
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Zip | 11220-3662
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Country | US
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Telephone | 718-853-2828
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Fax | 718-975-0040
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. WELLMAN CHEUNG
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Credential | MD
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Telephone | 718-853-2828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 204223
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License Number State | NY
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