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General NPI Number Information
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NPI Number | 1326757972
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Entity Type | Organization
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Legal Business Name | LI TEH WU
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Dates
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Enumeration Date | 11/22/2022
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Last Update Date | 12/05/2022
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Provider Practice Location Address
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Address Line | 8806 55TH AVE
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City | ELMHURST
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State | NY
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Zip | 11373-4437
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Country | US
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Telephone | 631-775-3098
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Fax |
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Provider Business Mailing Address
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Address Line | 8806 55TH AVE
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City | ELMHURST
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State | NY
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Zip | 11373-4437
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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 | DIRECTOR OF CREDENTIALING
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Name | ZELDA MARTIN
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Credential |
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Telephone | 631-372-1375
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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