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General NPI Number Information
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NPI Number | 1386842854
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Entity Type | Organization
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Legal Business Name | CHIA DER WU,MD,PC
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Dates
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Enumeration Date | 07/06/2007
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Last Update Date | 11/02/2011
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Provider Practice Location Address
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Address Line | 13347 SANFORD AVE SUITE 2B
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City | FLUSHING
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State | NY
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Zip | 11355-5800
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Country | US
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Telephone | 718-762-2113
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Fax | 718-732-2859
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Provider Business Mailing Address
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Address Line | 13347 SANFORD AVE SUITE 2B
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City | FLUSHING
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State | NY
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Zip | 11355-5800
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Country | US
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Telephone | 718-762-2113
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Fax | 718-732-2859
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHIA DER WU
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Credential | M.D.
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Telephone | 718-762-2113
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 152365
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License Number State | NY
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