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General NPI Number Information
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NPI Number | 1043455868
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Entity Type | Organization
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Legal Business Name | JUNG F WU MD PA
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Dates
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Enumeration Date | 12/08/2008
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Last Update Date | 12/08/2008
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Provider Practice Location Address
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Address Line | 605 BROAD AVE SUITE 201
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City | RIDGEFIELD
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State | NJ
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Zip | 07657-1697
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Country | US
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Telephone | 201-941-9117
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Fax | 201-941-9107
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Provider Business Mailing Address
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Address Line | 15 S VIRGINIA CT
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City | ENGLEWOOD CLIFFS
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State | NJ
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Zip | 07632-2117
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SELF / OWNER
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Name | JUNG FAUG WU
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Credential | MD
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Telephone | 201-945-2481
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 25MA03121700
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License Number State | NJ
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